Management of patients with cervical spine trauma in the emergency department: a systematic critical appraisal of guidelines with a view to developing standardized strategies for clinical practice
| Autor: | Elisa Maria Fiorelli, Paola Bosco, Giorgio Costantino, Luigi Piero Solimeno, Pietro Bellone, Monica Solbiati, Elisa Gesu, Hayato Kurihara, Giorgio Conte, Mattia Bonzi, Matteo Ferrari, Giulio Bertani, Barbara Brignolo Ottolini |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Citation index Scopus Nice Guidelines as Topic Guidelines Cervical spine Internal Medicine medicine Humans Complete Agreement Cervical spine trauma computer.programming_language business.industry Cervical Cord Correction Emergency department Emergency Department Reference Standards Critical appraisal Systematic review Family medicine Emergency Medicine Wounds and Injuries CE-Systematic reviews and meta-analysis business Emergency Service Hospital computer |
| Zdroj: | Intern Emerg Med Internal and Emergency Medicine |
| ISSN: | 1970-9366 |
| Popis: | Several guidelines on the evaluation of patients with suspected cervical spine trauma in the Emergency Department (ED) exist. High heterogeneity between different guidelines has been reported. Aim of this study was to find areas of agreement and disagreement between guidelines, to identify topics in which further research is needed and to provide an evidence-based cervical spine trauma algorithm for ED physicians. The three most relevant guidelines published on cervical spine trauma in the last 10 years were selected screening websites of the main scientific societies and through the comparison of a normalized Google Scholar and SCOPUS citation index. We compared the selected guidelines through seven a-priori defined questions. In case of disagreement between the guidelines or if the quality of evidence appeared low, evidence from published systematic reviews on the topic was added to build an evidence-based algorithm for approach to spinal trauma in the ED. The three selected guidelines were: NICE 2016, Eastern Association for the Surgery of Trauma 2009 and American Association of Neurological Surgeons and Congress of Neurological Surgeons 2013. We found complete agreement on one question, partial agreement for one questions, no agreement for two questions, while agreement was not assessable for 3 questions. The agreement between different guidelines and the evidence on which recommendations are based is low. An attempt to build an evidence-based algorithm has been made. More studies are needed on many topics. |
| Databáze: | OpenAIRE |
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