Sometimes, a simple bedside exam performed by a skilled physician is superior to a high-tech CT scan, a Loyola University Health System study has found.
Researchers found that physicians' bedside exams did a better job than CT scans in predicting which patients would need to return to the operating room to treat complications such as bleeding.
"The low cost, simple, but elegant neurological exam appears to be superior to a routine CT scan in determining return to the operating room," researchers report in the Journal of Neurosurgery.
Patients typically receive CT scans following open brain surgery to remove tumors, repair aneurysms, treat brain injuries, etc. But practices vary. Some surgeons order CT scans right after surgery. Others wait until the following morning.
There are downsides. CT scans cost hundreds of dollars and expose patients to radiation. Transporting patients to scanning machines "involves multiple personnel of varying skills and nursing staff who are taken away from their other unit responsibilities," researchers wrote. "These scans also often interfere with work flow efficiencies of the radiology department."
The lead author of the study is Dr. Ahmad Khaldi, chief resident in the Department of Neurological Surgery at Loyola University Chicago Stritch School of Medicine. The senior author is Dr. Thomas Origitano, chairman of the Department of Neurological Surgery.
Researchers examined the records of 251 patients who received CT scans within 24 hours of surgery at Loyola. They included 133 patients who received routine scans within seven hours of surgery and 108 patients who received routine scans between 8 hours and 24 hours after surgery. None of the routine scans predicted which patients would need to return to the operating room.