Pattern and Predictors of Positive Head Computed Tomography Scan in Mild Traumatic Brain Injury at Addis Ababa Burn Emergency and Trauma Hospital

Abstract

Background

Mild traumatic brain injury (mTBI) is one of the most common causes of emergency department presentation. However, using a head computed tomography (CT) scan for mTBI is improperly justified.

Methodology

A cross-sectional study was conducted in the largest teaching hospital in Ethiopia to assess the patterns and predictors of positive head CT scans in patients with mTBI. The study, conducted over 3 months, included 407 patients of the 1–85 years of age group. The majority of them were from Addis Ababa and Oromia, and most presented within six hours. An exhaustive sampling technique was used, and data were collected by structured questionnaire and analyzed by SPSS version 25.0. Bivariate and multivariate logistic regression were done for association, and a P value < .05 at the 95% confidence interval was declared statistically significant.

Results

The male-to-female ratio was found to be 3.7:1. Out of 407 CT scan images of patients with mTBI, 320 (78.6%) were male and 87 (21.4%) were female.

A majority of trauma, 165 (40.5%), was caused by road traffic accidents (RTAs) by motor vehicles, followed by assaults, 136 (33.4%), and fall-down accidents, 94 (23.1%). The majority of RTAs occurred in the 16–35 age group. The assault mechanism was mostly a stick, metal road, stone, sharp object, or unknown. The majority of falling accidents occurred from height.

The study found that 43.2% of patients experienced loss of consciousness (LOC), with 37.2% experiencing less than 5 minutes of LOC. The most common complaint was headache, with 34.2% experiencing it. A total 371 patients (91.2%) had a Glasgow Coma Scale score of 15.

A positive finding was found in 30.2%. Linear skull fracture at 33.6% followed by depressed skull fracture at 31.1% was the most common finding. Male patients with a late presentation, unknown duration of loss of consciousness, and vomiting were associated with positive results.

Conclusion

A high prevalence of positive head scans was revealed in our study. Sex, duration of time, loss of consciousness, vomiting, and cerebrospinal fluid leak were the predictors of a positive head CT scan.