International Journal of Emergency Medicine最新文献

{"title":"Successful transcatheter treatment of large right pulmonary artery to left atrial fistula: a case series and literature review.","authors":"Hojjat Mortezaeian, Farshad Jafari, Mahmoud Meraji, Avisa Tabib, Hamid Reza Pouraliakbar, Fatemeh Naderi","doi":"10.1186/s12245-024-00770-7","DOIUrl":"https://doi.org/10.1186/s12245-024-00770-7","url":null,"abstract":"<p><strong>Introduction: </strong>Cyanotic congenital heart diseases are among the most serious anomalies among newborns. A rare type of this condition is direct communication between the right pulmonary artery and left atrium, which presents mostly in adolescence and adulthood. Large shunts, however, should be corrected as soon as possible, considering their potential to cause congestive heart failure.</p><p><strong>Case presentation: </strong>Two 2- and 13-year-old patients with this pathologic communication complained of exertional dyspnea and central cyanosis. Their physical exams were prominent, with a low oxygen saturation level. The diagnostic modalities used, electrocardiogram, chest X-ray, echocardiogram, CT scan, and selective angiography of the pulmonary arteries, showed right-to-left abnormal blood flow through the right pulmonary artery and left atrium shunt. Finally, both patients were treated successfully by a transcatheter occluder without any complications or follow-up complaints.</p><p><strong>Discussion: </strong>The right pulmonary artery and left atrium abnormal congenital connections are rare causes of central cyanosis, mostly present with exertional dyspnea and cyanosis during adolescence or early adulthood. Transthoracic echocardiography, contrast-enhanced CT scans, and angiography of the pulmonary arteries make the diagnosis. The treatment has emerged during the last two decades, shifting from surgical treatment for severe cases to interventional percutaneous strategies, leaving the surgery for cases with no appropriate location for the application of interventional therapy.</p><p><strong>Conclusion: </strong>Considering the potentially life-threatening complications of the untreated right pulmonary artery and left atrium fistulas, such as thromboembolic events, early diagnosis is crucial. However, treating these patients is not always straightforward, and strategies should be selected based on the connecting fistula's anatomical features, location, size, and tortuosity. Although endovascular treatment is the preferred option, some patients need to be treated with surgical procedures due to their structural characteristics.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"17 1","pages":"179"},"PeriodicalIF":2.0,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of online expert interview-based research training on medical trainees' knowledge and confidence: a mixed-methods design.","authors":"Arif Alper Cevik, Fikri M Abu-Zidan","doi":"10.1186/s12245-024-00764-5","DOIUrl":"10.1186/s12245-024-00764-5","url":null,"abstract":"<p><strong>Background: </strong>Research training is important for medical trainees, because it improves their critical thinking, problem-solving, and the application of scientific principles to clinical practice. The COVID-19 Pandemic, which limited trainees' access to hospitals, had also disrupted traditional research training. The International Emergency Medicine Education Project introduced the online Fundamentals of Research in Medicine course to support trainees. The course was designed as an expert interview. This format intended to foster a relaxed learning environment and promote experience sharing rather than transferring only factual information about research. This study assesses the course's effect on participants' perceived knowledge and confidence in research concepts.</p><p><strong>Methods: </strong>A prospective observational mixed-methods research was conducted through the International Emergency Medicine Education Project's online platform. Pre- and post-course surveys measured participants' perceived knowledge and confidence levels across 16 research-related topics. Quantitative survey data were analysed using the Wilcoxon Signed-Rank test, and qualitative feedback was evaluated to explore participants' experiences.</p><p><strong>Results: </strong>A total of 272 participants enrolled in the course. 168 participants started, and 52 (19.2%) completed the pre- and post-surveys and the course completion exam. Medical students and interns, as well as participants from Africa and Asia, comprised the majority. Most participants were from India. 78.8% of the participants were from low-income or lower-middle-income countries. Participants' perceived knowledge and confidence significantly improved after completing the course, p < 0.001, with large effect sizes (-0.902 and - 0.819, respectively). Qualitative feedback highlighted the course's clarity, simplicity, and effectiveness of the informal interview format. Some participants suggested adding more visual aids and detailed explanations for complex topics.</p><p><strong>Conclusions: </strong>The online course, designed as an interview format, effectively enhanced participants' perceived research knowledge and confidence. Future studies should incorporate objective measures of research skill acquisition from online courses and evaluate the long-term impact on participants' academic and professional development.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"17 1","pages":"178"},"PeriodicalIF":2.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Airway, breathing, cellphone: a new vital sign?","authors":"Samuel I Garcia, Ashley Jacobson, Gregory P Moore, Jesse Frank, Wyatt Gifford, Samantha Johnson, Donell Lazaro-Paulina, Aidan Mullan, Alexander S Finch","doi":"10.1186/s12245-024-00769-0","DOIUrl":"10.1186/s12245-024-00769-0","url":null,"abstract":"<p><strong>Introduction: </strong>In emergency medicine, triage encompasses more than the initial prioritization of treatment; it also includes decisions about the most suitable level of care and disposition for each patient. However, the increasing use of mobile technology by patients in the emergency department (ED) introduces a new factor. This study aims to explore the relationship between patients' cellphone use at the time of initial assessment and final disposition in the ED.</p><p><strong>Methods: </strong>A prospective, cross-sectional study was conducted on 292 patients who presented to the ED between 9/1/2021 and 8/9/2022. Patients were stratified into two cohorts based on their behavior during the initial assessment: actively using a cell phone (n = 32) or not using a cell phone (n = 259). Final disposition was dichotomously recorded as admission or discharge. Hospital admission, hospital observation, and admission to the ED observation unit were consolidated into the combined category of admission.</p><p><strong>Results: </strong>Patients not actively using their cell phone on initial assessment exhibited a discharge rate of 64%, while those engaged with their cellphones displayed notably higher dismissal rates at 94%. The calculated odds ratio (OR) of 8.4 (95% confidence interval: 1.96-36.0, p = 0.004) underscores a significantly heightened likelihood of dismissal among individuals actively using their cellphones, suggesting a potential association between cellphone use and a reduced probability of hospital admission.</p><p><strong>Conclusion: </strong>The study suggests an association between cellphone use during initial ED assessment and higher discharge rates. While this introduces a novel concept, the study's potential contribution to more informed and efficient triage decisions warrants careful consideration in future research and clinical applications.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"17 1","pages":"177"},"PeriodicalIF":2.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11583604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142692900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fundamentals of emergency care support: a blended learning model to improve emergency and trauma care in a low-income country.","authors":"Noman Ali, Qamar Riaz, Salman Muhammad Soomar, Shahan Waheed, Uzma Khan, Nadeem Ullah Khan","doi":"10.1186/s12245-024-00726-x","DOIUrl":"10.1186/s12245-024-00726-x","url":null,"abstract":"<p><strong>Background: </strong>The burden of time-sensitive illnesses that require emergency care, such as heart diseases, respiratory tract infections, and road traffic injuries, is the leading cause of premature deaths. The healthcare providers of the emergency care system lack the essential knowledge and skills across different healthcare levels in our country. In this paper, we aim to describe the development and initial implementation of a blended learning curriculum for teaching and training non-EM-trained physicians working in the emergency departments of our country.</p><p><strong>Methods: </strong>We used a previously articulated curriculum designed by Patricia Thomas and David Kern. The model included general and specific need assessment, defining goals and objectives, selecting teaching and learning strategies, and implementation and evaluation plans.</p><p><strong>Results: </strong>Based on the need assessment, a module-based blended learning model has been designed with well-defined goals and objectives covering knowledge and skills. This ten-week module-based course focuses on four areas of critically emergent conditions, i.e., trauma, shock, difficulty in breathing, and altered mental status. Evaluation will be made by comparing the pre and post-test scores of the participants.</p><p><strong>Conclusion: </strong>We have developed a blended course to teach non-EM-trained physicians working in the ED of our country. We hope that through this blended learning model, we will be able to adequately train our physicians working in the emergency department without any formal training in EM, which will lead to improved patient care and outcomes.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"17 1","pages":"176"},"PeriodicalIF":2.0,"publicationDate":"2024-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11566297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling three accessory spleens in one patient: a rare case report and literature review.","authors":"Hamdah Hanifa, Hussein Alhussein, Lissa Mahmandar, Sara Kadi, Mahfoud Najjar, Ahmad Alhaj","doi":"10.1186/s12245-024-00758-3","DOIUrl":"10.1186/s12245-024-00758-3","url":null,"abstract":"<p><strong>Background: </strong>During embryogenesis, the spleen undergoes intricate developmental processes, originating from mesenchymal cells in the dorsal mesentery. An accessory spleen, a common anomaly found in autopsies and abdominal CT scans, can often be mistaken for different types of tumors. To the best of our knowledge, this is the first case in Syria documenting the occurrence of 3 accessory spleens in a patient who had previously undergone splenectomy.</p><p><strong>Case presentation: </strong>A 33-year-old male presented with right hypochondrium pain, sharp and radiating to the right flank, exacerbated by movement and large meals. Past medical history included mild Irritable Bowel Syndrome (IBS) and splenectomy due to a traumatic accident in childhood. On admission, vital signs were stable, with abdominal tenderness in the right upper quadrant. Laboratory investigations showed normal values. Ultrasound revealed a lobulated mass at the right adrenal gland (4.5 × 5 cm) with an isoechoic to hypoechoic texture. Multi-slice computed tomography (MSCT) Scan showed multiple nodules in the right adrenal gland, regular in shape, exerting a compressive mass effect, and significant lymphadenopathy around the abdominal aorta. Elevated metanephrine levels raised suspicion of an extra-adrenal pheochromocytoma. Laparoscopic surgery was performed, revealing accessory spleens and normal adrenal tissue with no malignancy.</p><p><strong>Conclusion: </strong>Healthcare providers should consider accessory spleens as a differential diagnosis for masses near the adrenal glands. Multiple accessory spleens in the adrenal region can complicate cases. Accessory spleens in uncommon locations like the adrenal glands can be challenging to diagnose and manage.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"17 1","pages":"175"},"PeriodicalIF":2.0,"publicationDate":"2024-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619944","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facial high-pressure injection injury with air in a child.","authors":"S A Simonis, D H de Lange","doi":"10.1186/s12245-024-00756-5","DOIUrl":"10.1186/s12245-024-00756-5","url":null,"abstract":"<p><strong>Background: </strong>High-pressure injection injuries are rare injuries and are frequently underestimated due to the limited external damage. Because of their association with occupational activities, these injuries are predominantly seen in hands. Facial involvement in such traumas is extremely rare. The difference in facial anatomy compared to the extremities demands careful consideration of both associated complications and treatment options.</p><p><strong>Case: </strong>A 6-year-old girl with no significant medical history was presented to the Emergency Department with a high-pressure injection injury to her right eye with a high-pressure cleaner. This resulted in injection of air at a pressure of 8 bar into the eye. She developed significant subcutaneous emphysema in the facial and neck regions. Additionally, intraorbital and intracranial emphysema were identified without any fractures. Treatment consisted of inpatient observation and antibiotic treatment. The patient was discharged after one day of observation for continued antibiotic treatment at home. Two weeks later, the patient had no residual symptoms and there were no signs of secondary infection.</p><p><strong>Conclusion: </strong>High-pressure injection injuries to the face are rare and demand a different approach compared to the most common high-pressure injection injuries to the extremities. The nature of the injected material is paramount in choosing the appropriate treatment. This case illustrates that a high-pressure injection injury with air in the facial region, leading to extensive emphysema, can be managed conservatively with antibiotic therapy and inpatient observation.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"17 1","pages":"174"},"PeriodicalIF":2.0,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11552189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142635783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stroke in the young: infective endocarditis due to mitral valve prolapse leading to acute ischemic stroke and subsequent hemorrhagic transformation.","authors":"Kajal Arora, Amarja Ashok Havaldar","doi":"10.1186/s12245-024-00755-6","DOIUrl":"10.1186/s12245-024-00755-6","url":null,"abstract":"<p><strong>Background: </strong>Stroke in young needs an individualized approach before considering thrombolysis. Here we present a case of undiagnosed mitral valve prolapse presenting with stroke due to associated infective endocarditis. Young stroke patients presenting with fever need a panoramic approach. This 39-year-old female with a background history of fever and loss of weight for two months presented to the emergency department with a history of altered sensorium and aphasia. The Magnetic Resonance Imaging (MRI) showed a hyperacute infarct. Hence, thrombolysis with alteplase was considered. Post thrombolysis, the patient had a parenchymal bleed. The diagnostic evaluation yielded stroke secondary to infective endocarditis because of undiagnosed mitral valve prolapse.</p><p><strong>Conclusion: </strong>Mitral valve prolapse is not associated with stroke in young patients. However, the undiagnosed infective endocarditis and subsequent septic emboli led to an increased risk. Emergency physicians and intensivists should anticipate infective causes before considering thrombolysis, as the results could be counterproductive.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"17 1","pages":"173"},"PeriodicalIF":2.0,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11549870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The need for implementing a standardized, evidence-based emergency department discharge plan for optimizing adult asthma patient outcomes in the UAE, expert meeting report.","authors":"Rasha Buhumaid, Ashraf Alzaabi, Bassam Mahboub, Mohamed Nizam Iqbal, Hamad Alhay Alhameli, Mohamed Ghazi Al-Mafrachi, Kenneth Charles Dittrich, Thiagarajan Jaiganesh","doi":"10.1186/s12245-024-00757-4","DOIUrl":"10.1186/s12245-024-00757-4","url":null,"abstract":"<p><strong>Background: </strong>Asthma is a common chronic respiratory inflammatory disease that adversely affects patients' quality of life (QoL) and overall well-being. When asthma is not adequately controlled, there is a higher risk of exacerbations and hospitalizations, thereby increasing the direct and indirect costs associated with the treatment and productivity loss. Overreliance on SABA and underutilization of ICS in the management of asthma can result in suboptimal treatment and poor asthma control. Patients who visit the emergency department are more likely to have poorly controlled asthma. Ensuring that these patients are provided with an evidence-based treatment plan during discharge can help reduce the risk of future exacerbations and consequently reduce the burden on the UAE healthcare system.</p><p><strong>Methods: </strong>A joint task force comprising experts from the Emirates Society of Emergency Medicine (ESEM) and Emirates Thoracic Society (ETS) reviewed published evidence and updated guidelines in asthma management to optimize the post-discharge recommendations.</p><p><strong>Results: </strong>The ESEM-ETS experts' joint task force has developed a step-by-step plan for emergency department/hospital discharge, which is based on the GINA 2023 guideline recommendations and the medications available in the UAE. By adhering to this structured plan, emergency department physicians can play a crucial role in improving asthma care, long-term patient outcomes, and the utilization of healthcare resources.</p><p><strong>Conclusions: </strong>Prioritizing patient education and ensuring patients are equipped with the best-suited asthma treatment plans prior to discharge can help ED physicians improve patient outcomes and reduce healthcare resource utilization in UAE hospitals.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"17 1","pages":"172"},"PeriodicalIF":2.0,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology and outcomes of critically ill patients in the emergency department of a tertiary teaching hospital in Rwanda.","authors":"Laurent Gamy Kamunga B, Courtney J Bearnot, Kyle D Martin, Doris L Uwamahoro, Giles N Cattermole","doi":"10.1186/s12245-024-00736-9","DOIUrl":"10.1186/s12245-024-00736-9","url":null,"abstract":"<p><strong>Background: </strong>The introduction of Emergency Medicine in Rwanda in 2015 has been associated with a mortality reduction in patients presenting to Kigali University Teaching Hospital (KUTH). In the context of increasing numbers of critically ill patients presenting to Emergency Departments (ED) globally, the aim of this study was to describe the characteristics of critically ill patients, the critical care interventions performed, and the outcomes of critically ill patients presenting to the KUTH ED with the goal of informing future research into the root causes of mortality of critically ill ED patients and of identifying high yield topics for didactic and procedural training.</p><p><strong>Methods: </strong>A descriptive observational prospective cohort pilot study analyzed all patients ≥15 years who presented to KUTH between April and June 2022 with modified South African Triage Scores of Red with alarm, Red without alarm, and Orange.</p><p><strong>Results: </strong>Of 320 patients, 66.9% were male and median age was 40 years. Patients were triaged as Orange (65.3%), Red without alarm (22.8%), and Red with alarm (11.9%). Presentations were categorized as: medical emergencies (48.0%), traumatic injury (44.5%), and surgical emergencies (7.6%). Median length of stay was 31 h (IQR 28, 56) and boarding was 23 h (IQR 8, 48). Overall mortality was 12.2% and highest among medical emergencies (16.5%, p = 0.048) and increased significantly with triage color: Red with alarm (47.4%), Red without alarm (16.4%), and Orange (4.3%, p < 0.0001). Cardiopulmonary resuscitation (CPR) (10.3%), endotracheal intubation (8.8%), and vasopressor administration (3.1%) were the most frequent critical interventions performed. Survival after cardiac arrest was 9.1% and 32.1% after intubation. Mortality was associated with the following interventions: CPR, intubation, and use of vasopressors (p < 0.05).</p><p><strong>Conclusions: </strong>This pilot study identified the most common critical care interventions performed and a high mortality among patients who required these interventions in the ED of a tertiary teaching hospital in Rwanda. These findings will inform didactics and procedural training for emergency care providers. Future research should focus on the root causes of mortality in these specific patient populations and identify areas of system strengthening to reduce mortality.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"17 1","pages":"170"},"PeriodicalIF":2.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Peri-injury symptomatology as predictors of brain computed tomography (CT) scan abnormalities in mild traumatic brain injury (mTBI).","authors":"Sihi Vasista, Josue Saint-Fleur, Neera Kapoor, Latha Ganti","doi":"10.1186/s12245-024-00754-7","DOIUrl":"10.1186/s12245-024-00754-7","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to identify predictors of brain CT abnormalities in patients who sustained a mild traumatic brain injury (mTBI).</p><p><strong>Methods: </strong>Retrospective observational cohort of adult patients with mTBI (Glasgow Coma Score 13-15) that occurred within the preceding 24 h.</p><p><strong>Results: </strong>2548 (91%) of the cohort had a brain CT and 698 (27%) demonstrated abnormal findings. The most frequently observed CT abnormalities were bleeding (638, 25%) and fractures (190, 7.4%). Multivariate logistic regression analysis revealed several significant predictors associated with the presence of brain CT abnormalities including older age [P < 0.0001], male sex [P < 0.0001], loss of consciousness [P = 0.0041], associated vomiting [P = 0.0011], alteration of consciousness (AOC) [P = 0102], and GCS score [P < 0.0001]. This was a robust model with an R² of 14.2%.</p><p><strong>Conclusion: </strong>In this retrospective analysis, older age, male sex, the presence of loss of consciousness or alteration in consciousness, lower GCS score, and associated vomiting were found to be significant predictors of having an abnormal brain CT. These findings highlight the importance of considering these factors when determining the necessity of brain CT scans in patients with mTBI and suggest that existing clinical decision rules may be limited. These findings may also help to inform clinical decision rules. Early identification of individuals at a higher risk of CT abnormalities may assist in appropriate management and allocation of healthcare resources.</p>","PeriodicalId":13967,"journal":{"name":"International Journal of Emergency Medicine","volume":"17 1","pages":"171"},"PeriodicalIF":2.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11539808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}