The findings from this study provide additional context to risk factors currently in use as components in guidelines for the management of mild traumatic brain injury (mTBI) in the ED setting, contrasting high risk predictors such as signs of a skull base fracture with variables shown to have limited predictive capabilities for tICH such as anticoagulant use, post-traumatic headache and intoxication.

Though these findings require further investigation, we have demonstrated that the methodology of a structured systematic review and meta-analysis could be applied to identify problematic aspects and serve as a foundation for updating existing guidelines.

The literature was searched using MEDLINE, EMBASE and Web of Science databases. Reference lists of major literature was cross-checked. The outcome variable was tICH on CT. Odds ratios (OR) were pooled for independent risk factors.

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