Methods:

This study is a cross-sectional study of MHT (GCS: 13-15) cases who referred to emergency department of a level one trauma center, Mashhad, Iran, from October 2017 to March 2018. The screening performance characteristics of ACEP recommendations for performing brain CT scan in these patients were calculated.

Results:

500 patients with a mean age of 37.97±15.96 years were evaluated. Based on level one recommendations, 73 (14.6%) patients had to be assessed by brain CT scan. 67 (91.8%) were assessed and 6 (8.2%) were not assessed based on decision of their in-charge physician. According to level two recommendations, 125 (25.0%) patients did not need brain CT scan, 85 (68%) of whom had been assessed (all normal). Performing brain CT scan according to the level one recommendation of ACEP’s clinical policy showed 29.6% sensitivity (95% CI: 13.75 to 50.18) and 86.3% specificity (95% CI: 82.68 to 89.14). The overall ACEP’s clinical policy for neuroimaging of adults with MTBI showed sensitivity and specificity of 92.59%(95% CI:‎ 75.71 to 99.09) and 26.4%(95% CI: 22.51 to 30.65), respectively.

Conclusion:

ACEP’s clinical policy has a high-level sensitivity for using brain CT scan in detection of probable TBI in patients with MHT.