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The Canadian CT Head Rule reduced the need for CT scans more than the New Orleans Criteria in minor head injury

Clinical impact ratings Emergency medicine Surgery—neurosurgery

Key Words: craniocerebral trauma • decision support systems (clinical) • tomography (x ray computed)

The first 150 words of the full text of this article appear below.

METHODS
Design: external validation of 2 previously developed clinical prediction guides (CCHR and NOC).

Setting: 4 university hospitals in the Netherlands.

Patients: 3181 patients 16 years of age (mean age 41 y, 71% men) who presented within 24 hours after blunt head injury and had a Glasgow Coma Scale (GCS) score of 13–14 or 15 with 1 of the following: history of loss of consciousness, short term memory deficit, amnesia for the traumatic event, post-traumatic seizure, vomiting, severe headache, intoxication with alcohol or drugs, use of anticoagulants or history of coagulopathy, injury above the clavicles, or neurological deficit. Patients who could not receive a CT scan because of concurrent injury or contraindications were excluded.

Description of prediction guide: the CCHR was developed in patients who had a GCS score of 13–15, loss of consciousness, no neurological deficit, no seizure, and no anticoagulation; were >16 years of age; and had 5 factors . . . [Full text of this article]

Marcia Edmonds, MD

University of Western Ontario, London, Ontario, Canada