ปัจจัยที่มีความสัมพันธ์ต่อการพบความผิดปกติในเอกซเรย์คอมพิวเตอร์สมองในผู้ป่วยบาดเจ็บที่ศีรษะ ไม่รุนแรง: การศึกษาเปรียบเทียบย้อนหลังในโรงพยาบาลสมเด็จพระยุพราชกระนวน: Factors Associated with Abnormal Findings on Brain Computed Tomography  in Patients with Mild Traumatic Brain Injury:  A Retrospective Comparative Study at Kranuan Crown Prince Hospital

พิชชาพร พรรณวุฒิ

Authors

พิชชาพร พรรณวุฒิ -

Keywords:

Mild traumatic brain injury; CT Brain; associated factors; community hospital; head injury, การบาดเจ็บที่ศีรษะไม่รุนแรง, เอกซเรย์คอมพิวเตอร์สมอง, ปัจจัยที่มีความสัมพันธ์, โรงพยาบาลชุมชน, การบาดเจ็บที่ศีรษะ, Mild traumatic brain injury, CT Brain, associated factors, community hospital, head injury

Abstract

Background: Mild traumatic brain injury (MTBI) is a common emergency condition encountered in community hospital emergency departments. Computed tomography of the brain (CT Brain) plays a crucial role in detecting intracranial hemorrhage that requires urgent management. However, performing CT scans without appropriate screening criteria may lead to unnecessary healthcare costs and avoidable radiation exposure.

Objective: To determine the prevalence and types of abnormalities detected on CT Brain and to identify factors associated with these abnormalities in patients with mild traumatic brain injury (MTBI) at Kranuan Crown Prince Hospital, Khon Kaen Province.

Methods: This retrospective analytical study was conducted using medical records of patients diagnosed with mild traumatic brain injury (Glasgow Coma Scale score 13–15), aged 15 years and older, who underwent CT Brain at Kranuan Crown Prince Hospital between January 1, 2023, and December 31, 2025. Independent variables included sex, age, mechanism of injury, clinical signs and symptoms, underlying diseases, and medication history. Data were analyzed using descriptive statistics, Chi-square test, Fisher’s exact test, and multivariate logistic regression. Statistical significance was set at p < 0.05.

Results: A total of 440 patients met the inclusion criteria, of whom 58.6% were male. CT Brain abnormalities were detected in 81 patients, accounting for 18.4% (95% CI: 14.8–22.0). The most common abnormality was subarachnoid hemorrhage (65.4%), followed by subdural hemorrhage (60.5%), intracerebral hemorrhage (35.8%), and epidural hemorrhage (27.2%). Multiple types of abnormalities were observed in 56.8% of cases.

Multivariate analysis identified motorcycle-related accidents (Adjusted OR = 2.15, 95% CI: 1.27–3.65, p = 0.004) and age < 60 years (Adjusted OR = 1.78, 95% CI: 1.06–3.00, p = 0.030) as independent factors significantly associated with CT Brain abnormalities.

Regarding clinical outcomes, no patients required neurosurgical intervention, referral, or experienced mortality. At one-month follow-up, 99.5% of patients had a Glasgow Outcome Scale score of 5.

Conclusion: Motorcycle-related accidents and age below 60 years were independent risk factors associated with CT Brain abnormalities in patients with MTBI in a community hospital setting. The identified risk factors may serve as a basis for developing appropriate clinical decision-making guidelines for CT Brain utilization in MTBI patients in community hospitals, thereby reducing unnecessary imaging and minimizing radiation exposure without clear indications.

Keywords: Mild traumatic brain injury; CT Brain; associated factors; community hospital; head injury

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