Abstract:
OBJECTIVE:To assess whether clinical variables might be useful in selecting patients who will have an acute intracranial abnormality seen in head computed tomographic scans (HCT). DESIGN:Retrospective study. SETTING:Medical intensive care unit (MICU) in a tertiary teaching hospital. MEASUREMENTS:Medical records of patients admitted to the MICU who underwent HCT between January 1, 1994, and December 31, 1995, were reviewed. Patients with acute intracranial abnormalities (HCT-positive) and those without new acute findings (HCT-negative) were compared on various clinical variables, including demographics, indications for obtaining the HCT (mental status change, neurologic deficit, fever, seizures), coagulation profiles, when the HCT was performed (at admission or after admission), and ordering physician. MAIN RESULTS:Of 297 HCTs obtained in 230 patients, 37% (109/297) were positive. When the clinical variables were examined univariately, only the presence of a neurologic deficit (70% vs. 37%; difference, 33%; p < .001) differed significantly between positive and negative HCTs. Multivariate analysis confirmed that only the frequency of a new neurologic deficit differed significantly in the two groups (p < .001; odds ratio, 3.9; 95% confidence interval, 2.3-6.4). In patients without neurologic deficits, only the presence of seizures was associated with a positive HCT (p < .01: logistic regression). The presence of either neurologic deficit or seizures best predicted a positive HCT: sensitivity 0.81, specificity 0.53, positive predictive value 0.50, and negative predictive value 0.83. CONCLUSION:Among MICU patients, the presence of either neurologic deficit or seizures is associated with the presence of an acute intracranial abnormality seen in HCT, but the association is not powerful enough to reliably depend on these clinical variables to select patients for HCTs in the MICU.
journal_name
Crit Care Medjournal_title
Critical care medicineauthors
Rafanan AL,Kakulavar P,Perl J 2nd,Andrefsky JC,Nelson DR,Arroliga ACdoi
10.1097/00003246-200005000-00008subject
Has Abstractpub_date
2000-05-01 00:00:00pages
1306-9issue
5eissn
0090-3493issn
1530-0293journal_volume
28pub_type
杂志文章abstract::The authors have examined cardiopulmonary resuscitation (CPR) skills retention in a police force initially trained to instructor level performance skills as defined by the 1977 American Heart Association Instructor Manual. In 1977, the entire Winnipeg Police Force received a basic 8-h course of CPR training with recor...
journal_title:Critical care medicine
pub_type: 杂志文章
doi:10.1097/00003246-198011000-00011
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doi:10.1097/CCM.0b013e3181f9f9c7
更新日期:2010-12-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:1999-01-01 00:00:00
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journal_title:Critical care medicine
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2011-03-01 00:00:00
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pub_type: 杂志文章
doi:10.1097/00003246-199409000-00017
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pub_type: 杂志文章,随机对照试验
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更新日期:1997-09-01 00:00:00
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更新日期:2011-02-01 00:00:00
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更新日期:2011-04-01 00:00:00
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更新日期:2020-01-01 00:00:00
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更新日期:1999-08-01 00:00:00
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更新日期:2001-04-01 00:00:00
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更新日期:2013-05-01 00:00:00
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更新日期:2009-05-01 00:00:00
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更新日期:2003-04-01 00:00:00
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更新日期:2017-09-01 00:00:00