{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:21:43Z","timestamp":1787840503934,"version":"build-2784847793"},"reference-count":7,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>We sought to determine the difference between Canadian CT Head Rule (CCHR) indicated imaging rates and actual imaging rates for patients with mild traumatic brain injuries (mTBIs) at a rural emergency department (ED) without in-house computed tomography (CT). In addition, we compared CCHR adherence at a hospital without CT to previous publications from centres with CT to determine if rural populations receive less CT imaging for minor head traumas when indicated by the CCHR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective chart review explored individuals who presented to a rural ED (no in-house CT scanner) with a primary diagnosis of mild head injury or concussion between 1 January 2017 and 31 December 2021. Information regarding CCHR criteria, transfer status and patient demographics was collected. Descriptive analyses were completed to determine the percentage of patients who received appropriate transfer for imaging, did not receive transfer for imaging when indicated and received unnecessary transfer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 124 charts met our inclusion criteria (17 [12.1%] charts excluded), with 25.8% transferred to the nearest hospital for CT imaging. After applying the CCHR criteria to our charts, 62.1% were indicated for CT. Of the 62.1%, only 35.1% were transferred for imaging (51.2% of high-risk and 16.7% of medium-risk).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>By exploring CT rates for mTBIs in a rural Canadian ED, we found low transfer rates (35.1%) of CCHR-indicated patients for imaging needed to guide further healthcare decisions. This work highlights a discrepancy within the Canadian healthcare system between rural and urban centres and allows for opportunities to help narrow the gap in health care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Nous avons cherch\u00e9 \u00e0 d\u00e9terminer la diff\u00e9rence entre les taux d\u2019imagerie indiqu\u00e9s par le Canadian CT Head Rule (CCHR, r\u00e8glement canadien relatif \u00e0 la tomodensitom\u00e9trie de la t\u00eate) et les taux d\u2019imagerie r\u00e9els pour les patients souffrant de traumatismes cranioc\u00e9r\u00e9braux l\u00e9gers (TCCL) dans un service d\u2019urgence rural ne disposant pas d\u2019une tomographie par ordinateur interne. En outre, nous avons compar\u00e9 l\u2019adh\u00e9sion au CCHR dans un h\u00f4pital sans tomographie par ordinateur \u00e0 des publications ant\u00e9rieures provenant de centres avec tomographie par ordinateur afin de d\u00e9terminer si les populations rurales re\u00e7oivent moins d\u2019imagerie par tomodensitom\u00e9trie pour les traumatismes cr\u00e2niens mineurs lorsque le CCHR l\u2019indique.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>M\u00e9thodes:<\/jats:title>\n                    <jats:p>\n                      Cette \u00e9tude r\u00e9trospective des dossiers a explor\u00e9 les personnes qui SE sont pr\u00e9sent\u00e9es \u00e0 une urgence rurale (sans tomodensitom\u00e8tre interne) avec un diagnostic primaire de traumatisme cr\u00e2nien l\u00e9ger ou de commotion c\u00e9r\u00e9brale entre le 1\n                      <jats:sup>er<\/jats:sup>\n                      janvier 2017 et le 31 d\u00e9cembre 2021. Les informations concernant les crit\u00e8res du CCHR, l\u2019\u00e9tat de transfert et les donn\u00e9es d\u00e9mographiques des patients ont \u00e9t\u00e9 recueillies. Des analyses descriptives ont \u00e9t\u00e9 r\u00e9alis\u00e9es pour d\u00e9terminer le pourcentage de patients ayant re\u00e7u un transfert appropri\u00e9 pour l\u2019imagerie, n\u2019ayant pas re\u00e7u de transfert pour l\u2019imagerie quand c\u2019\u00e9tait indiqu\u00e9 et ayant re\u00e7u un transfert inutile.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>R\u00e9sultats:<\/jats:title>\n                    <jats:p>Au total, 124 dossiers r\u00e9pondaient \u00e0 nos crit\u00e8res d\u2019inclusion [17 (12,1%) dossiers exclus], dont 25,8% ont \u00e9t\u00e9 transf\u00e9r\u00e9s \u00e0 l\u2019h\u00f4pital le plus proche pour une imagerie par tomodensitom\u00e9trie. Apr\u00e8s avoir appliqu\u00e9 les crit\u00e8res du CCHR \u00e0 nos dossiers, 62,1% d\u2019entre eux \u00e9taient indiqu\u00e9s pour une tomodensitom\u00e9trie. Sur ces 62,1%, seuls 35,1% ont \u00e9t\u00e9 transf\u00e9r\u00e9s pour imagerie (51,2% de haut risque, 16,7% de risque moyen).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>En explorant les taux de tomodensitom\u00e9trie pour les TCCL dans un service d\u2019urgence rural canadien, nous avons constat\u00e9 de faibles taux de transfert (35,1%) des patients recommand\u00e9s par le CCRH pour une imagerie n\u00e9cessaire dans le but de guider les d\u00e9cisions de soins de sant\u00e9 ult\u00e9rieures. Ce travail met en \u00e9vidence un \u00e9cart dans le syst\u00e8me de sant\u00e9 canadien entre les centres ruraux et urbains et offre des opportunit\u00e9s pour aider \u00e0 r\u00e9duire l\u2019\u00e9cart dans les soins de sant\u00e9.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/cjrm.cjrm_1_24","type":"journal-article","created":{"date-parts":[[2024,11,9]],"date-time":"2024-11-09T02:00:13Z","timestamp":1731117613000},"page":"167-172","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Canadian CT head rule adherence in a rural hospital without in-house computed tomography"],"prefix":"10.4103","volume":"29","author":[{"given":"Matthew D.","family":"Lavery","sequence":"first","affiliation":[{"name":"Department of Medicine, Southern Medical Program, University of British Columbia, Kelowna, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rylen 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