Analysis of Computed Tomography Head Scan Data of Patients Requiring Emergency Care.

The aim of the study: To analyse the indications for performing CT scans on patients requiring emergency care, effectiveness of CT as well as age and sex group distribution of changes detected during CT. To evaluate the correlation between CT time and the detection of intracranial changes in patients with a traumatic brain injury. Tasks: 1. To identify the age group of patients with and without traumatic brain injuries on which CT imaging scans are most frequently performed. 2. To analyse the indications for performing CT scans on patients requiring emergency care and effectiveness of CT. 3. To find out age and sex group distribution of acute cerebral circulation problems. 4. To analyse the pathological changes that are most commonly detected in patients with traumatic brain injuries and to find out their distribution by age and sex as well as the relationship between these changes and comorbid conditions. 5. To evaluate the correlation between CT time and the detection of intracranial changes in patients with traumatic brain injuries. Materials and Methods: A retrospective study was conducted for the purpose of the thesis. The study sample included 472 patients who underwent CT scanning at Kaunas Clinics Emergency Centre. The analysis of the patient data covered the period from 1 April 2019 to 30 April 2019. The study included patients who underwent CT head scanning at the Emergency Centre. The study excluded patients whose medical records did not provide all the information we needed for the purpose of the study. Results: Total of 472 head CT examinations were preformed in patients admitted to ED. Traumatic head injuries were detected in 226 (47,9%) patients. There was a total of 246 (52,1%) non-trauma patients. The following is the distribution of non-trauma patients by age group: the group of patients aged 18 to 39 accounted for 9.8% of the patients; those in the 40-59-year age group accounted for 19.9% of the patients; people between the ages of 60 to 79 made up 43.9% of the patients and those aged 80 and older accounted for 26.4% of the patients. The most common indication for performing CT head scan for non-trauma patients was a neurologic deficit (52%). Acute changes in CT head scans were detected in 27.5% of the patients. The following is the distribution of acute cerebral circulation problems by age groups: patients between the ages of 60 to 79 made up 51.6% of the patients; those aged 80 and older accounted for 34.4% of the patients; those in the 40-59-year age group accounted for 12.5% of the patients, and the group of those aged 18 to 39 made up 1.6% of the patients. Acute ischemic stroke accounted for 84.4% of acute cerebral circulation problems, whereas acute haemorrhagic stroke accounted for 15.6% of the afore-mentioned cerebral circulation problems. Traumatic subdural haemorrhage (29.6%) was the most commonly diagnosed pathology in trauma patients. 94.9% of the patients with traumatic pathology underwent CT imaging within less than one hour and only 5.1% of the patients had to wait longer than one hour to receive CT scans. Conclusions: CT head scans in patients without traumatic head injuries are mostly performed on those who are older than 60 years. In patients with traumatic head injuries CT scanning is most frequently performed on those younger than 80 years. CT head scanning is more often performed on patients with suspected acute non-traumatic pathology. A neurologic deficit is the most common indication for performing CT scans in non-trauma patients. Based on the analysis of the effectiveness of CT, acute changes were detected only in 27.6% of the patients. The incidence of acute cerebral circulation problems increases between the ages of 40 to 79. Acute ischemic stroke is diagnosed more often than acute haemorrhagic stroke. Changes in the brain due to traumatic injuries are more likely to be detected in men between the ages of 18 to 79. However, in the patient group aged 80 and older these traumatic injuries are most commonly detected in women. Traumatic subdural haemorrhage is the most common pathology detected after a traumatic brain injury. Intracranial injuries, cerebral contusion or haemorrhage are more often detected in patients who receive CT scans within less than one hour