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CT Findings for Patients Presenting to the Emergency Department with Altered Mental Status

نوع الإرسال:

المؤلفون

Razan Daghistani1;

1 Department of Radiology, King Abdulaziz University, Jeddah, Saudi Arabia

المستخلص

Background: Altered mental status (AMS) is a common emergency department (ED) presentation with diverse etiologies. Noncontrast computed tomography (NCCT) of the head is frequently requested to exclude acute intracranial pathology, yet its diagnostic yield remains variable.Objective: To evaluate the radiological findings on NCCT head examinations in nontraumatic ED patients presenting with AMS, and to assess whether additional clinical information influenced diagnostic yield.Methods: We retrospectively reviewed consecutive NCCT head examinations requested from the ED for AMS. Patients with trauma or known intracranial pathology were excluded. Demographic data, request descriptors, and imaging findings were extracted from electronic records. Findings were classified as acute abnormalities, incidental/chronic, or normal. Statistical comparisons were performed using chi-square and T test, with p<0.05 considered significant.Results: Of 500 CT head examinations reviewed, 121 (24.2%) met inclusion criteria. The mean patient age was 69.6 years (range 19–95), with 55 females and 65 males. Twenty-six patients (21.0%) had acute abnormal findings: 23 (88.5%) acute infarcts and 3 (11.5%) intracranial hemorrhages. Ninety-five patients (78.5%) had normal or incidental findings, including 11 (9.2%) with chronic microvascular disease or remote infarcts. There was no statistically significant difference in age or gender between patients with normal and abnormal scans. Additional clinical information was present in 35 requests (28.9%), but was not significantly associated with abnormal findings (p=0.292).Conclusion: In this single-center cohort, NCCT head yielded acute abnormalities in only one-fifth of nontraumatic AMS patients, with ischemic infarction being the most common finding. Clinical descriptors in imaging requests did not significantly predict abnormal scans. While NCCT remains essential for excluding life-threatening pathology, the relatively low yield underscores the need for improved clinical decision tools to guide imaging in AMS.

المواضيع الرئيسية

Special Education & Home Economy

الكلمات المفتاحية

Altered Mental Status
Emergency Department
Head CT
Diagnostic Yield
Ischemic Stroke
Intracranial Hemorrhage

رخصة

Journal License

هذا العمل مرخص بموجب رخصة Attribution-ShareAlike 4.0 International

Volume 4, Proceeding of the 16th Annual Meeting of Radiology Society of Saudi Arabia (RSSA)

منشور

صفحات 51 - 60

الملفات

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عدد مرات مشاهدة المقال

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المراجع

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