Outcomes Following Minor Head Abdominal Trauma. Abstract, Executive Summary and211 Final Report, 1 Aug 94-31 Jul 98

摘要

The long-term objectives of this proposal were: (1) to evaluate the current211u001epractice of mandatory hospitalization for observation only following two specific 211u001etypes of injury; Minimal Head Injury (MHI) and Minor Abdominal Trauma, and (2) to 211u001edevelop practice guidelines that could reliably exclude significant injuries 211u001ewithout hospitalization. 2500 trauma patients admitted to four Level I Trauma 211u001eCenters were prospectively evaluated. All patients underwent a physical 211u001eexamination followed by cranial or abdominal CT scanning. Patients were 211u001esubsequently admitted and observed for the development of missed injuries. For 211u001eboth MHI and minor abdominal trauma, no single or combination of findings on 211u001ephysical examination could predict an injury on CT scanning. The negative 211u001epredictive value of cranial and abdominal CT scanning was 99.94% (lower 95% CI 211u001e99.72%) and 99.64% lower 95%CI 99.30 respectively. Thus we conclude that patients 211u001ewith a cranial or an abdominal CT scan, obtained on a helical or spiral CT 211u001escanner, that shows no intracranial or intraabdominal injury can be safely 211u001edischarged from the ED without a period of either in-patient or out-patient 211u001eobservation.