Brain Computed Tomography in Stimulant Poisoning with Altered Consciousness

Chen, Hsien-Yi; Chaou, Chung-Hsien; Chen, Chun-Kuei; Yu, Jiun-Hao; Chen, Po‐Cheng; Huang, Ching-Tai; Seak, Chen-June; Liao, Shao-Feng

doi:10.1016/j.jemermed.2020.04.037

Cited by 1 publication

(6 citation statements)

References 21 publications

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“…Of 26 studies, 11 were performed in the ED, 5 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 3 in the ICU, 20 , 21 , 22 4 in an inpatient unit, 23 , 24 , 25 , 26 and 8 in mixed settings. 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 Fifteen studies were performed in the US, 5 , 10 , 11 , 18 , 20 , 22 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 33 , 34 and 4 in Europe 13 , 16 , 21 , 31 ( Table ).…”

Section: Resultsmentioning

confidence: 99%

“…The studies were appraised using the Joanna Briggs Institute quality assessment. We rated 11 studies as high quality 12 , 16 , 19 , 22 , 23 , 27 , 28 , 31 , 32 , 33 , 34 and 15 studies as medium quality 5 , 10 , 11 , 13 , 14 , 15 , 17 , 18 , 20 , 21 , 24 , 25 , 26 , 29 , 30 ; none of the studies were rated as low quality (eTables 2-4 in the Supplement ).…”

Section: Resultsmentioning

confidence: 99%

“…Of 26 studies, 11 were performed in the ED, 3 in the ICU, 4 in an inpatient unit, and 8 in mixed settings . Fifteen studies were performed in the US, and 4 in Europe (Table).…”

Section: Resultsmentioning

confidence: 99%

“…The studies were appraised using the Joanna Briggs Institute quality assessment. We rated 11 studies as high quality and 15 studies as medium quality; none of the studies were rated as low quality (eTables 2-4 in the Supplement).…”

Section: Resultsmentioning

confidence: 99%

“…Of 26 studies, 11 were performed in the ED, 5,[10][11][12][13][14][15][16][17][18][19] 3 in the ICU, [20][21][22] 4 in an inpatient unit, [23][24][25][26] and 8 in mixed settings. [27][28][29][30][31][32][33][34] Fifteen studies were performed in the US, 5,10,11,18,20,22,[24][25][26][27][28][29][30]33,34 and 4 in Europe 13,16,21,31 (Table).…”

Section: Study Characteristicsmentioning

confidence: 99%

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Use of Computed Tomography of the Head in Patients With Acute Atraumatic Altered Mental Status

et al. 2022

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ImportanceThe usefulness of computed tomography of the head (CTH) in patients with acute-onset atraumatic altered mental status (AMS) is poorly understood, but use in these patients remains high.ObjectiveTo evaluate the use of CTH (event rate) in patients with AMS and the positive outcome event rate of the performed CTH studies.Data SourcesThe PubMed/MEDLINE, PubMed Central, Embase, and CINAHL databases were searched using predefined Boolean parameters. All studies that met inclusion criteria until January 31, 2022, were included.Study SelectionRandomized clinical trials and observational, cohort, and case-control studies were included. Conference abstracts, reviews, letters, case reports, case series, systematic literature, and meta-analyses were excluded.Data Extraction and SynthesisThe systematic literature review was performed per Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Data were independently extracted by 2 authors. Data were pooled using a random-effects method.Main Outcomes and MeasuresEvent rate of CTH use in patients with acute atraumatic AMS. The CTH event rates and positive CTH event rates were calculated with 95% CIs.ResultsOf 9338 studies identified, 26 qualified for the systematic review and 25 for the meta-analysis. The 25 studies in the meta-analysis included a total of 79 201 patients. The CTH event rate was 94% (proportion, 0.94; 95% CI, 0.76-1.00), and the positive CTH event rate was 11% (proportion, 0.11; 95% CI, 0.07-0.15). There was significant heterogeneity among the studies included (I2 &gt; 50%, P &lt; .001), for which a random-effects model was used. There was significant publication bias, as evident by an asymmetric funnel plot. There was no fluctuation of the results during the sensitivity analysis, which reassured the reliability of the data.Conclusions and RelevanceIn this meta-analysis, CTH use among patients with acute-onset atraumatic AMS was very high with a low yield. Large-scale studies are needed to guide clinical decision-making in such a situation.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…Of 26 studies, 11 were performed in the ED, 3 in the ICU, 4 in an inpatient unit, and 8 in mixed settings . Fifteen studies were performed in the US, and 4 in Europe (Table).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%