Perfil da utilização de tomografia computadorizada em trauma cranioencefálico leve em pronto-socorro

• Autor(a) principal: Pereira, Bernardo Antonio Dreveck
• Data de Publicação: 2021
• Outros Autores: Cade, Gabriela Sech Emery, Souza, Gabriely Amaral de, Gomes, Luiza Arena Silveira
• Tipo de documento: Trabalho de conclusão de curso
• Idioma: por
• Título da fonte: Repositório do Centro Universitário Braz Cubas
• Texto Completo: https://repositorio.cruzeirodosul.edu.br/handle/123456789/3875
• topic: Traumatismos craniocerebrais; omografia computadorizada por Raios X; Exames médicos; CNPQ::CIENCIAS DA SAUDE::MEDICINA

INTRODUCTION: Traumatic brain injury (TBI) is defined as any aggression that affects anatomically or functionally the skull or brain and is among the main causes of emergency service demand. It affects 100 to 300 people per 100,000 inhabitants, and the main victims are male under 40 years old. The main causes are falls and traffic accidents. Computed tomography (CT) of the skull is the test of choice for screening injuries in cases of TBI, but its routine use is not recommended. OBJECTIVE: To evaluate the indication of CT scan of the skull in patients diagnosed with mild traumatic brain injury. METHODS: This is a retrospective observational, descriptive study, with analysis of secondary data from medical records. The individual analysis of medical records of patients with traumatic brain injury seen in the Emergency Room of the Hospital do Trabalhador in the period from January 1 to December 31, 2019 was performed. The analysis of the collected data was performed using SPSS v.25.0. The guideline "Diagnosis and Conduct in the Patient with Mild Traumatic Brain Injury" of the Brazilian Society of Neurosurgery (SBN) was applied retrospectively. RESULTS:We evaluated 1403 medical records, of which 70.4% (n=988) underwent skull tomography (CT). According to the guideline used, of these, 371 patients (37.6%) had no indication, and within this group, 13 patients had positive CT findings (0,9%). In the entire population who had CT, 109 patients had positive CT findings. The outcomes of the 371 patients were: discharge without surgical intervention in 92.5% and hospitalization in 5.3%, with two individuals requiring surgical treatment, with admission CTs without findings, and two others evolving to death. CONCLUSION:Although the retrospective application of the SBN guideline led to a reduction in the absolute number of requested CTs, with a savings of R$36,150.24, its expenses could be justified, considering that the guideline was not able to identify patients who evolved with clinically significant injuries.