Mild TBI in the Emergency Department

Mild TBI is one of the most frequent causes of emergency department (ED) admission and is characterized by an increasing incidence. Brain computed tomography (CT) is a fundamental diagnostic tool to assess the presence and extent of any brain lesions and is commonly used in the ED for timely diagnosis. In particular, it allows to identify structural damage, such as hemorrhages, which could put the patient's life at risk if not treated promptly. However, the use of CT involves exposure to ionizing radiation, increases healthcare costs and can slow down the flow of patients in the ED. Considering that it is estimated that between 85% and 95% of patients with mild TBI do not have any brain lesions, a careful clinical evaluation is essential in indicating this investigation. These elements generate significant variability in the use of CT in mild TBI.

Several families of criteria and guidelines have been developed to support clinical decisions in this area, including the Canadian CT Head Rule, the Nexus II criteria, the New Orleans criteria and the National Institute for Health and Care Excellence (NICE) guidelines on head trauma. Although these criteria have been validated in multiple studies, their main objective is the identification of positive CT. This represents a limitation, since in many cases marginal brain injuries do not cause clinically relevant consequences or require specific interventions or treatments.

In this context, the present study aims to answer several research questions. First, the variability of CT use in Italian EDs will be analyzed, with the aim of identifying any discrepancies and the factors that determine them. The ultimate goal is to improve the quality of care for patients with mild head trauma. Second, the validity of the main tools proposed in the literature to support the clinical decision on the use of CT will be evaluated. Finally, the study aims to develop a new decision-making tool that can help ED physicians identify patients at risk of clinically relevant events in the short term, in order to facilitate a more accurate use of CT.

• Validate the most common scores [Срок оценки: September 2026 - August 2027]
• Develop a new score to improve existing ones. [Срок оценки: January 2027 - August 2027]