Research Article Assessment and Predicting Factors of Repeated Brain Computed Tomography in Traumatic Brain Injury Patients for Risk-Stratified Care Management: A 5-Year Retrospective Study Preeda Sumritpradit, 1 Thitipong Setthalikhit, 1 and Sorayouth Chumnanvej 2 1 Acute Care Unit, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Tailand 2 Neurosurgery Division, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Tailand Correspondence should be addressed to Sorayouth Chumnanvej; sorayouth.chu@mahidol.ac.th Received 21 April 2016; Revised 7 August 2016; Accepted 21 August 2016 Academic Editor: Changiz Geula Copyright © 2016 Preeda Sumritpradit et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background and Objective. To determine the value of repeated brain CT in TBI cases for risk-stratifed care management (RSCM) and to identify predicting factors which will change the neurosurgical management afer repeated brain CTs. Methods. A 5-year retrospective study from January 2009 to August 2013 was conducted. Te primary outcome was the value of repeated brain CT in TBI cases. Te secondary outcome is to identify predicting factors which will change the neurosurgical management afer repeated brain CTs. Results. Tere were 145 consecutive patients with TBI and repeated brain CT afer initial abnormal brain CT. Forty-two percent of all cases ( = 61) revealed the progression of intracranial hemorrhage afer repeated brain CT. In all 145 consecutive patients, 67.6% of cases ( = 98) were categorized as mild TBI. For mild head injury, 8.2% of cases (=8) had undergone neurosurgical management afer repeated brain CT. Only 1 from 74 mild TBI patients with repeated brain CT had neurosurgical intervention. Clopidogrel and midline shif more than 2 mm on initial brain CT were signifcant predicting factors to indicate the neurosurgical management in mild TBI cases. Conclusion. Routine repeated brain CT for RSCM had no clinical beneft in mild TBI cases. 1. Introduction Traumatic brain injury (TBI) patients with equivocal fndings of brain computed tomography (CT) at the initial presen- tation frequently have repeated brain CTs. Repeated brain CT is commonly practiced at several trauma centers without protocol in place. Utilization of brain CT has increased over time; however, efects on outcome and associated risks are unknown. Brain CT may provide earlier identifcation for a type of traumatic brain injury. As a result, this patient will be receiving more aggressive neurosurgical intervention. In Ramathibodi Hospital, there is no protocol in place regarding repeated brain CT for TBI patients and it is controversy. So, based on physician preference and patient safety, repeated brain CT is still exercised. Regarding the patient safety, the risk-stratifed care management (RSCM) is the interested procedure to assign a health risk status to a patient and to directly improve care management. Repeated brain CT is the option and the only one of the investigation of choice for the equivocal condition to establish TBI patient risk status as an objective tool. Te apparent beneft of repeated brain CT was determined. 2. Material and Methods A retrospective study of consecutive adult patients admitted to Acute Care Unit, Surgery Department, Faculty of Medicine Ramathibodi Hospital, afer head injury was carried out afer IRB approval. Data were collected from January 2009 to August 2013. Inclusion criteria were age more than ffeen years and duration of admission less than seventy-two hours. Patients who were treated with supportive treatment afer ini- tial brain CT were recruited. Tere were 145 cases potentially eligible. Variables collections including age, sex, underlying Hindawi Publishing Corporation Neurology Research International Volume 2016, Article ID 2737028, 7 pages http://dx.doi.org/10.1155/2016/2737028