Abstract:

Objective To investigate the necessity of routine repeat CT after traumatic brain injury. Methods One hundred and three patients with traumatic brain injury without emergency operations at admission were selected and randomly divided into routine repeat CT group (n=53) and non-routine repeat CT group (n=50). Age, gender, score of Glasgow coma scale (GCS) at admission, mechanism of injury, time between first CT scan and injury （HCT1）, type and location of injury, volume of hematoma, blood coagulation function at admission, length of stay at intensive care unit (ICU), length of hospital stay, score of GCS at discharge and hospital charge were compared between groups. Related factors of progressive hemorrhage were investigated by Logistic regression analysis. Patients in routine-repeat CT group were subdivided into three groups according to GCS scores (3 to 8 points group, 9 to 12 points group and 13 to 15 points group), and the necessity for routine repeat CT was evaluated. Results There were significant differences in score of GCS at discharge, length of stay at ICU and length of hospital stay between these two groups (P＜0.01). There was no significant difference in hospital charge between these two groups （P＞0.05）. Logistic regression analysis indicated that age, fibrin degradation products (FDP), international normalized ratio (INR) and D-dimer concentration (DD) were risk factors for progressive hemorrhage (OR＞1, P＜0.05). Lower GCS score at admission, HCT1 and platelet count (PLT) were associated with a greater likelihood of developing progressive hemorrhage (OR<1, P<0.05). In routine repeat CT group, 53 patients underwent 161 times of repeat CT, 1 (4%) of the 25 patients with mild traumatic brain injury (13 to 15 points group) developed progressive injury and changed the therapy, and 18 （64.3%）of the 28 patients with moderate and severe traumatic brain injury (3 to 8 points group and 9 to 12 points group) changed the therapy. Conclusion Routine repeat CT has definite value in patients with moderate and severe traumatic brain injury.

Key words: traumatic brain injury, CT, progressive hemorrhage