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- Publisher Website: 10.1136/bmjsem-2018-000445
- Scopus: eid_2-s2.0-85059481605
- PMID: 30687512
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Article: Concussion assessment in the emergency department: A preliminary study for a quality improvement project
Title | Concussion assessment in the emergency department: A preliminary study for a quality improvement project |
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Authors | |
Keywords | concussion diagnosis study sporting injuries head |
Issue Date | 2018 |
Citation | BMJ Open Sport and Exercise Medicine, 2018, v. 4, n. 1, article no. e000445 How to Cite? |
Abstract | Background In sport, concussion is assessed using the Sports Concussion Assessment Tool (SCAT) 5 and managed with return to play guidelines. Similar, user-friendly tools are rarely, if ever, used in the emergency department (ED). Objectives To evaluate a modified concussion assessment tool designed for the ED (ED-CAT) in patients presenting with a head injury and to identify variables that predict 30-day reattendance. Methods A preliminary, prospective, evaluation in a quality improvement project was conducted in one hospital in South Wales. Patients were recruited if they were over 13 years, and either did not have an ED-CT head scan or had a scan with no acute changes. The primary outcome was 30-day reattendance. Results 40 patients were recruited, 18 of whom had a CT scan. 37 were discharged on the same day with advice, two discharged the next day and one was admitted. Three (7.5%) patients reattended the department. Predictors of reattendance were headache score (median 3.0 vs 5.0; p<0.05), pressure in head score (2.0 vs 5.0; p<0.05), nausea/vomiting score (1.0 vs 3.0; p<0.05), dizziness score (1.0 vs 4.0; p<0.05), blurred vision score (0 vs 4.0; p<0.01), balance problems score (0 vs 4.0; p<0.05), sensitivity to light and confusion score (0 vs 4.0; p<0.01), orientation score (1. 0 vs 0; p<0.05) and immediate memory score (5.0 vs 4.0; p<0.05). Conclusions Key symptoms and signs predicted 30-day reattendance. The ED-CAT requires validation and refinement in a larger population to produce a short, practical, user-friendly, relevant tool for ED head injury assessment. |
Persistent Identifier | http://hdl.handle.net/10722/292097 |
ISSN | 2023 Impact Factor: 3.9 2023 SCImago Journal Rankings: 1.253 |
PubMed Central ID | |
ISI Accession Number ID |
DC Field | Value | Language |
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dc.contributor.author | Mistry, Dylan A. | - |
dc.contributor.author | Rainer, Timothy H. | - |
dc.date.accessioned | 2020-11-17T14:55:45Z | - |
dc.date.available | 2020-11-17T14:55:45Z | - |
dc.date.issued | 2018 | - |
dc.identifier.citation | BMJ Open Sport and Exercise Medicine, 2018, v. 4, n. 1, article no. e000445 | - |
dc.identifier.issn | 2055-7647 | - |
dc.identifier.uri | http://hdl.handle.net/10722/292097 | - |
dc.description.abstract | Background In sport, concussion is assessed using the Sports Concussion Assessment Tool (SCAT) 5 and managed with return to play guidelines. Similar, user-friendly tools are rarely, if ever, used in the emergency department (ED). Objectives To evaluate a modified concussion assessment tool designed for the ED (ED-CAT) in patients presenting with a head injury and to identify variables that predict 30-day reattendance. Methods A preliminary, prospective, evaluation in a quality improvement project was conducted in one hospital in South Wales. Patients were recruited if they were over 13 years, and either did not have an ED-CT head scan or had a scan with no acute changes. The primary outcome was 30-day reattendance. Results 40 patients were recruited, 18 of whom had a CT scan. 37 were discharged on the same day with advice, two discharged the next day and one was admitted. Three (7.5%) patients reattended the department. Predictors of reattendance were headache score (median 3.0 vs 5.0; p<0.05), pressure in head score (2.0 vs 5.0; p<0.05), nausea/vomiting score (1.0 vs 3.0; p<0.05), dizziness score (1.0 vs 4.0; p<0.05), blurred vision score (0 vs 4.0; p<0.01), balance problems score (0 vs 4.0; p<0.05), sensitivity to light and confusion score (0 vs 4.0; p<0.01), orientation score (1. 0 vs 0; p<0.05) and immediate memory score (5.0 vs 4.0; p<0.05). Conclusions Key symptoms and signs predicted 30-day reattendance. The ED-CAT requires validation and refinement in a larger population to produce a short, practical, user-friendly, relevant tool for ED head injury assessment. | - |
dc.language | eng | - |
dc.relation.ispartof | BMJ Open Sport and Exercise Medicine | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.subject | concussion | - |
dc.subject | diagnosis | - |
dc.subject | study | - |
dc.subject | sporting injuries | - |
dc.subject | head | - |
dc.title | Concussion assessment in the emergency department: A preliminary study for a quality improvement project | - |
dc.type | Article | - |
dc.description.nature | published_or_final_version | - |
dc.identifier.doi | 10.1136/bmjsem-2018-000445 | - |
dc.identifier.pmid | 30687512 | - |
dc.identifier.pmcid | PMC6326330 | - |
dc.identifier.scopus | eid_2-s2.0-85059481605 | - |
dc.identifier.volume | 4 | - |
dc.identifier.issue | 1 | - |
dc.identifier.spage | article no. e000445 | - |
dc.identifier.epage | article no. e000445 | - |
dc.identifier.isi | WOS:000596798200131 | - |
dc.identifier.issnl | 2055-7647 | - |