When a patient presents to the emergency room with an acute altered mental state, a computed tomography (CT) scan of the head is frequently performed. The outcomes of positive CT tests and their connection to changes in clinical treatment are assessed. The study was conducted by the Preferred Reporting Items for Systematic Reviews and Meta-analyses standard and the PubMed, CINAHL, Embase, and PubMed Central databases were searched. The chosen studies ranged from the year 2019 to 2023. Five studies totaling 13,172 patients were included in this analysis including two retrospective case-control studies, two cohort studies, and one observational, quasi-experimental research. The United States, Taiwan, Italy, Israel, and India were the locations of the studies. The outcomes of the included studies were hemorrhage, mass effect, hydrocephalus, worsening of previous findings, intra-cerebral hemorrhage, space-occupying lesions, new ischemic infarction, hydrocephalus, bleeding, ischemic stroke, herniation, and intracranial hemorrhage. In most non-traumatic individuals with changed mental states, no significant CT abnormalities were found. Serious conditions were observed in a small percentage of individuals.
Key words: Altered mental status, delirium, computed tomography, emergency department, systemic review
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