| Author: | Tao, Yung Sang |
| Title: | Establishment of local CT head rule to reduce patient radiation dosage in emergency department |
| Advisors: | Ying, Tin Cheung Michael (HTI) |
| Degree: | DHSc |
| Year: | 2023 |
| Subject: | Head -- Tomography Hospitals -- Emergency services -- Management Hong Kong Polytechnic University -- Dissertations |
| Department: | Faculty of Health and Social Sciences |
| Pages: | xiv, 108 pages : color illustrations |
| Language: | English |
| Abstract: | Background and Objectives The study aimed to investigate the feasibility of setting up a computed tomography (CT) head selective rule for minor head injury patients in an accident and emergency department in Hong Kong. The study also verified the reliability of the rule in terms of its effectiveness and accuracy so that it may be used as a quick referencing guideline to use in routine clinical practice for reducing unnecessary CT head examinations, and reducing unnecessary radiation exposure dosage to patients. Methods The phase one study retrospectively reviewed the frequently seen signs and symptoms of minor head injury patients. The data were classified as various risk factors, and a chi-square test was employed to test the correlations between individual risk factor and positive CT head scan result. The phase two study applied the determined risk factors to justify the requested CT head scan prospectively. The multiple logistic regression model was employed to predict the correlation between CT head scan result and the risk factors. The risk factors with a high probability to yield a positive CT head scan result were selected to devise the CT head selective rule. Results Based on 2001 minor head injury patients who had a cranial CT scan in the phase one study, 127 (6.3%) patients had positive CT results. The risk factor of Glasgow Coma Scores lower than 15, patients aged above 65, loss of consciousness, and episodes of vomiting after minor head injury were the most frequent signs and symptoms related to a positive CT result. The phase two study applied three additional risk factors, including alcohol intoxication, an open head wound, and the ambulatory ability of the patient after a minor head injury. A total of 387 patients were included in this phase, and 40 (10.3%) were presented with a positive CT result. All patients with a positive CT result were presented with one or more risk factors. However, 33% of the CT scans were performed on patients with no risk factors. Thus, an avoidable radiation dosage would have been possible if the CT head rule was followed correctly. Conclusion To protect patients from potential harmful ionizing radiation, the local CT head rule should be applied for minor head injury patients to avoid unnecessary CT scanning. |
| Rights: | All rights reserved |
| Access: | restricted access |
Files in This Item:
| File | Description | Size | Format | |
|---|---|---|---|---|
| 7296.pdf | For All Users (off-campus access for PolyU Staff & Students only) | 6.26 MB | Adobe PDF | View/Open |
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