{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:42:20Z","timestamp":1787071340361,"version":"build-2736575974"},"reference-count":15,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"9","license":[{"start":{"date-parts":[[2025,9,1]],"date-time":"2025-09-01T00:00:00Z","timestamp":1756684800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Head trauma was the significant public health issue and a common cause of emergency department visits. Cranial computed tomography (CT) was widely used in its evaluation; however, overuse\u2014particularly in mild cases\u2014raises concerns about patient safety and healthcare efficiency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>This study aimed to evaluate the appropriateness of cranial CT use in head trauma patients, its relationship with Glasgow Coma Scale (GCS) scores, and the prevalence of potentially avoidable imaging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective study included 1,000 patients presenting with head trauma, who underwent cranial CT. Data collected included demographics, trauma mechanism, GCS score, CT findings, and indication for imaging. CT necessity was assessed using the Canadian CT Head Rule and New Orleans Criteria. CTs performed in patients with GCS 13\u201315, normal findings, and no guideline-based indications were classified as potentially avoidable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Of all patients, 65% were male, with a mean age of 42.1 \u00b1 20.7 years. Mild trauma (GCS 13\u201315) was present in 77.5% of cases. Intracranial pathology was detected in 35.9% overall, with higher rates in patients with moderate and severe trauma. Unnecessary CT imaging was found in 57% of all cases, and in 80.2% of mild trauma cases. A statistically significant association was found between lower GCS scores and intracranial findings (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Cranial CT was often overused in mild head trauma without adherence to clinical guidelines. Promoting the use of decision support tools and raising awareness among clinicians and patients are crucial for reducing potentially avoidable imaging, radiation exposure, and healthcare burden.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/njcp.njcp_472_25","type":"journal-article","created":{"date-parts":[[2025,9,27]],"date-time":"2025-09-27T17:00:21Z","timestamp":1758992421000},"page":"1027-1031","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Evaluation of Cranial Computed Tomography use and Guideline Compliance in Head Trauma Patients Presenting to the Emergency Department"],"prefix":"10.4103","volume":"28","author":[{"given":"H","family":"G\u00fcrb\u00fcz","sequence":"first","affiliation":[{"name":"Department of Emergency, Faculty of Medicine, Harran University, Sanliurfa, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Demir","sequence":"additional","affiliation":[{"name":"Deparment of Radiology, Faculty of Medicine, Kahramanmara\u015f S\u00fctc\u00fc \u0130mam University, Kahramanmara\u015f, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,9,27]]},"reference":[{"key":"R1-20260420","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1097\/00001199-200505000-00001","article-title":"Traumatic brain injury in the United States: Research and programs of the Centers for Disease Control and Prevention (CDC)","volume":"20","author":"Langlois","year":"2005","journal-title":"J Head Trauma Rehabil"},{"key":"R2-20260420","first-page":"27","article-title":"Determination of high risk factors for detection of abnormal cranial computed tomography in minor head injury","volume":"28","author":"Coban","year":"2015","journal-title":"Marmara Med J"},{"key":"R3-20260420","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.1016\/j.apmr.2010.05.017","article-title":"Position statement: Definition of traumatic brain \u0131njury","volume":"91","author":"Menon","year":"2010","journal-title":"Arch Phys Med Rehabil"},{"key":"R4-20260420","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1111\/acem.13061","article-title":"Computed tomography use for adults with head \u0131njury: Describing likely avoidable emergency department \u0131maging based on the Canadian CT Head Rule","volume":"24","author":"Sharp","year":"2017","journal-title":"Acad Emerg Med"},{"key":"R5-20260420","doi-asserted-by":"crossref","first-page":"e0293558","DOI":"10.1371\/journal.pone.0293558","article-title":"Overuse of computed tomography for mild head injury: A systematic review and meta-analysis","volume":"19","author":"Saran","year":"2024","journal-title":"PLoS One"},{"key":"R7-20260420","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1097\/HTR.0000000000000187","article-title":"Emergency department evaluation of traumatic brain \u0131njury in the United States, 2009\u20132010","volume":"31","author":"Korley","year":"2016","journal-title":"J Head Trauma Rehabil"},{"key":"R8-20260420","doi-asserted-by":"crossref","first-page":"1391","DOI":"10.1016\/S0140-6736(00)04561-X","article-title":"The Canadian CT Head Rule for patients with minor head injury","volume":"357","author":"Stiell","year":"2001","journal-title":"Lancet"},{"key":"R9-20260420","doi-asserted-by":"crossref","first-page":"688","DOI":"10.3171\/2009.2.JNS08909","article-title":"Prediction of intracranial computed tomography findings in patients with minor head injury by using logistic regression","volume":"111","author":"Saadat","year":"2009","journal-title":"J Neurosurg"},{"key":"R10-20260420","doi-asserted-by":"crossref","first-page":"1474","DOI":"10.1111\/acem.12824","article-title":"Understanding overuse of computed tomography for minor head \u0131njury in the emergency department: A triangulated qualitative study","volume":"22","author":"Melnick","year":"2015","journal-title":"Acad Emerg Med"},{"key":"R11-20260420","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.jacr.2016.08.032","article-title":"Overuse of head CT examinations for the \u0131nvestigation of minor head trauma: Analysis of contributing factors","volume":"14","author":"Klang","year":"2017","journal-title":"J Am Coll Radiol"},{"key":"R12-20260420","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1111\/acem.12625","article-title":"Emergency physician perceptions of medically unnecessary advanced diagnostic \u0131maging","volume":"22","author":"Kanzaria","year":"2015","journal-title":"Acad Emerg Med"},{"key":"R13-20260420","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1056\/NEJM200007133430204","article-title":"Indications for computed tomography in patients with minor head \u0131njury","volume":"343","author":"Haydel","year":"2000","journal-title":"N Engl J Med"},{"key":"R14-20260420","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1377\/hlthaff.27.6.1491","article-title":"Rising use of diagnostic medical \u0131maging \u0131n a large \u0131ntegrated health system","volume":"27","author":"Smith-Bindman","year":"2008","journal-title":"Health Aff (Millwood)"},{"key":"R15-20260420","doi-asserted-by":"crossref","first-page":"700","DOI":"10.1001\/jamapediatrics.2013.311","article-title":"The use of computed tomography in pediatrics and the associated radiation exposure and estimated cancer risk","volume":"167","author":"Miglioretti","year":"2013","journal-title":"JAMA Pediatr"},{"key":"R16-20260420","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1553-2712.2008.00295.x","article-title":"The effect of emergency department crowding on clinically oriented outcomes","volume":"16","author":"Bernstein","year":"2009","journal-title":"Acad Emerg Med"}],"container-title":["Nigerian Journal of Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/njcp.njcp_472_25","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:44:38Z","timestamp":1787067878000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/njcp.njcp_472_25"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9]]},"references-count":15,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.4103\/njcp.njcp_472_25","relation":{},"ISSN":["1119-3077","2229-7731"],"issn-type":[{"value":"1119-3077","type":"print"},{"value":"2229-7731","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,9]]},"assertion":[{"value":"2025-07-16","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-08-04","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}