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Detecting delayed intracranial hemorrhage with repeat head imaging in trauma patients on antithrombotics with no hemorrhage on the initial image: A retrospective chart review and meta-analysis
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Detecting delayed intracranial hemorrhage with repeat head imaging in trauma patients on antithrombotics with no hemorrhage on the initial image: A retrospective chart review and meta-analysis
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Detecting delayed intracranial hemorrhage with repeat head imaging in trauma patients on antithrombotics with no hemorrhage on the initial image: A retrospective chart review and meta-analysis
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Journal Article
Detecting delayed intracranial hemorrhage with repeat head imaging in trauma patients on antithrombotics with no hemorrhage on the initial image: A retrospective chart review and meta-analysis
2020
Overview
There is debate regarding routine repeat head computed tomography (CT) in blunt trauma patients on a pre-injury antithrombotic when the initial CT is negative for intracranial hemorrhage (ICH).
Retrospective chart review and systematic literature review with meta-analysis.
In the chart review, 32.1% did not have a repeat head CT and 67.9% did. The delayed ICH incidence between those with and without a repeat head CT was similar (1.7% vs 0, p = .3101). The current study was combined with the identified 24 studies. Delayed ICH with or without routine repeat CT was similar between antiplatelet and anticoagulant categories (1.4% vs. 1.3%, p = .5322). Delayed ICH was lower for patients without routine repeat CT compared to those with routine repeat CT (0.8% vs 1.7%, p = .0008). For this patient population, repeat scans should be discretionary. Routine repeat CT may identify a larger proportion of minor delayed ICH.
•Utility of routine repeat head CTs in trauma patients on antithrombotics is debatable.•Delayed ICH proportions are low and repeat scans should be discretionary.•Routine repeat CT produces higher delayed ICH proportions than discretionary CT.
Publisher
Elsevier Inc,Elsevier Limited
Subject
/ Anticoagulants - therapeutic use
/ Delayed intracranial hemorrhage
/ Female
/ Head
/ Head Injuries, Closed - complications
/ Head Injuries, Closed - diagnostic imaging
/ Humans
/ Intracranial Hemorrhage, Traumatic - diagnostic imaging
/ Intracranial Hemorrhage, Traumatic - epidemiology
/ Male
/ Patients
/ Software
/ Studies
/ Trauma
