Increase in non-contrast computerized tomography scans of the head following popular media stories about head injury

Introduction: On March 18, 2009, actress Natasha Richardson died after a head injury. It is possible that the rate of patients presenting with mild head injury and receiving computed tomographies (CTs) may have been influenced by the Richardson event. We hypothesized that there was a statistically significant increase in the rate of census-adjusted head CTs performed for mild trauma after March 16, 2009, compared to prior to this date. Methods: We included all with a non-contrast head CT performed from the emergency department (ED) between March 1 and April 15, 2009, for minor trauma. The primary outcome was the census-adjusted rate of head CTs per time (# of head CTs/census). We compared the census adjusted rate for the 2 weeks prior to 2 weeks after the accident. To document media dissemination we searched Lexis-Nexis for news stories mentioning "Richardson." Results: In the 2 weeks prior to March 16, 2009, the census-adjusted rate was 0.81% (95% CI 0.54-1.16) and there were no stories. The first media reports appeared on March 16, 2009, (n = 19) and quickly doubled (n = 40, n = 43) over the subsequent 2 days. The rate of CTs nearly doubled during the 2 weeks post accident 1.46% (1.10-1.91%). This absolute increase in rate percentage was statistically significant. (0.65%; 0.17 to 1.14%). Conclusion: The percentage of all ED patients seen with mild trauma tested with head CT almost doubled when comparing the pre-Richardson accident vs. post time periods. There was an increase in media reports of the accident that occurred rapidly after the event and peaked on day 3.