Towards evidence-based emergency medicine: Best BETs from the Manchester Royal Infirmary. BET 3: Observation is unnecessary following a normal CT brain in warfarinised head injuries: an update

Emerg Med J. 2014 Apr;31(4):339-42. doi: 10.1136/emermed-2014-203646.3.

Abstract

A short-cut review was carried out to determine whether patients on warfarin with a minor head injury can be discharged safely if they have a normal CT scan. 796 papers were found using the reported search, of which seven were considered relevant to the three-part question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses are shown in the accompanying table. It is concluded that the risk of delayed intracranial haemorrhage, at least in patients with an INR <3, is extremely small and discharge of these patients should be considered.

Publication types

  • Review

MeSH terms

  • Aged
  • Anticoagulants / adverse effects*
  • Atrial Fibrillation / drug therapy
  • Craniocerebral Trauma / diagnostic imaging
  • Craniocerebral Trauma / therapy*
  • Evidence-Based Emergency Medicine
  • Female
  • Humans
  • Intracranial Hemorrhages / chemically induced*
  • Patient Discharge*
  • Radiography
  • Warfarin / adverse effects*

Substances

  • Anticoagulants
  • Warfarin