Evaluation of clinical criteria to determine the need for cervical spine imaging in victims of blunt assault
| Autor: | Ruth K. Gershon, Lindsey Allred, Nisha Swaminathan, David P. Gordy, Joseph R Chaudry, Majid Khan, Seth T. Lirette |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty animal structures Low risk population Population Wounds Nonpenetrating Risk Assessment Neck Injuries 03 medical and health sciences 0302 clinical medicine Blunt Physiology (medical) medicine Craniocerebral Trauma Humans education Facial Injuries education.field_of_study business.industry Incidence (epidemiology) Incidence Significant difference General Medicine Middle Aged Cervical spine Neurology Blunt trauma Spinal Injuries 030220 oncology & carcinogenesis Emergency medicine Cervical Vertebrae Surgery Female Neurology (clinical) business Nexus (standard) 030217 neurology & neurosurgery |
| Zdroj: | Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia. 71 |
| ISSN: | 1532-2653 |
| Popis: | The purpose of this study is to evaluate effectiveness of clinical criteria, specifically the NEXUS Criteria, in determining the need for cervical spine imaging in victims of blunt assault to head and face. CT results from victims of blunt assault to the head and face were compared with presenting clinical findings. The presence or absence of cervical spine injury was correlated with positive NEXUS criteria to determine if the clinical criteria appropriately risk stratified patients in this population. Incidence of c-spine injury was 1.09% (7/641). For clinically significant injury, the incidence dropped to 0.16% (1/641). PPV of NEXUS criteria in blunt assault to the head and face for any injury in our study was 1.4% (95% CI: 0.6%–2.6%) compared to 2.7% (95% CI: 2.6%–2.8%) in the NEXUS validity study. PPV of NEXUS criteria in blunt assault to the head and face for significant injury in our study was 0.2% (95% CI: 0%–0.9%) compared to 1.9% (95% CI: 1.8%–2.0%) in the NEXUS validity study. The findings demonstrate a statistically significant difference between the PPV of NEXUS criteria in victims of blunt assault to the head and face when compared to all blunt trauma in the NEXUS validity study. This suggests that the clinical criteria do not adequately stratify this low risk population, leading to imaging over-utilization. Limited use of cervical spine imaging in victims of blunt assault will decrease radiation exposure and healthcare costs and will strengthen the validity of clinical risk stratification for more high-risk groups. |
| Databáze: | OpenAIRE |
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