Volume 18, Issue 2 (Pajouhan Scientific Journal, Winter 2020)                   Pajouhan Sci J 2020, 18(2): 114-121 | Back to browse issues page

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Hajari N, khaledian S, Zamanimehr N, Navkhasi S, Aslani M, Veisimiankali M J. Comparative study of the Three Criteria NEXUS II (National Emergency X-Ray Utilization Study) Canadian Computed Tomography Head Rule (CCHR) and American College of Emergency Physicians (ACEP) in the Diagnosis of Minor Head Trauma. Pajouhan Sci J 2020; 18 (2) :114-121
URL: http://psj.umsha.ac.ir/article-1-545-en.html
Comparative study of the Three Criteria NEXUS II (National Emergency X-Ray Utilization Study) Canadian Computed Tomography Head Rule (CCHR) and American College of Emergency Physicians (ACEP) in the Diagnosis of Minor Head Trauma
Navid Hajari1 , Shima Khaledian1 , Nahid Zamanimehr * 2, Sasan Navkhasi3 , Marzieh Aslani4 , Mohammad Javad Veisimiankali5
1- Emergency Medicine Specialist, Kurdistan University of medical science, Kurdistan, Iran
2- Emergency Medicine Specialist, Kurdistan University of medical science, Kurdistan, Iran , Nahid_mhzamani@yahoo.com
3- Department of Medical Surgical Nursing, Asadabad School of Medical Sciences, Asadabad, Iran
4- Department of Intensive Care Nursing, Asadabad School of Medical Sciences, Asadabad, Iran
5- Department of Nursing, Imam Ali Medical Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
Abstract:   (2814 Views)
Background and Objective: Disabilities caused by traumatic brain injuries affect millions of people worldwide, the use of CT scan (CT) is a method for the diagnosis of lesions. The aim of this study was to compare the criteria of sensitivity and specificity in determining the necessity of CT.
Materials and Methods: In this cross-sectional study, 100 traumatic patients who referred to the emergency department of Kosar Hospital with head injury were enrolled. On the basis of clinical examination and medical record for each system (ACEP, CCHR, Nexus) related clinical items recorded, and based on which scores were calculated for each. Data were analyzed using descriptive statistics, sensitivity and specificity, Chi-square, ROC curve, SPSS software version 20.
Results: Results showed that, in terms of gender, 47 (47%) were male and 53 (53%) were female. The mean age of patients was 46.02 ± 18.20 years. 37% had a head hematoma and 50% had a trauma. The sensitivity and specificity of the three criteria used (ACEP, Nexus and CCHR) were: 29.40% - 62.50%, 13.3% - 96.8% and 38.23% - 71.87%, respectively. Significance was observed between sensitivity and specificity of the three criteria (p <0.001).
Conclusion: The results of the sensitivity and specificity of the study were inconsistent with the findings of other studies. The proposed criteria of this study for CT may not have acceptable sensitivity and specificity.
Keywords: Sensitivity, Criteria for Clinical Decision Making, Head Minor Trauma
Full-Text [PDF 782 kb]   (990 Downloads)    
Type of Study: Research Article | Subject: Medicine & Clinical Sciences
Received: 2019/11/25 | Accepted: 2020/03/10 | Published: 2020/01/10
References
1. Saatman, K.E., et al., Classification of traumatic brain injury for targeted therapies. Journal of neurotrauma, 2008. 25(7): p. 719-738. [DOI]
2. 2. Gautschi, Frey, and Zellweger, Diagnostisches und therapeutisches Vorgehen bei Patienten mit leichtem Schädelhirntrauma. Praxis, 2007. 96(3): p. 53-60. [DOI]
3. 3. Kristman, V.L., et al., Methodological Issues and Research Recommendations for Prognosis After Mild Traumatic Brain Injury: Results of the International Collaboration on Mild Traumatic Brain Injury Prognosis. Archives of Physical Medicine and Rehabilitation, 2019. 95(3): p. 265-S277. [DOI]
4. 4. Fleminger, S. and J. Ponsford, Long term outcome after traumatic brain injury. BMJ 2005. 331(7530): p. 1419-20. [DOI]
5. 5. Bruns Jr, J. and W.A. Hauser, The Epidemiology of Traumatic Brain Injury: A Review. Epilepsia, 2003. 44(10): p. 2-10. [DOI]
6. 6. Yattoo, G. and A. Tabish, The profile of head injuries and traumatic brain injury deaths in Kashmir. Journal of trauma management & outcomes, 2008. 2(1): p. 5-5. [DOI]
7. 7. Luerssen, T.G., M.R. Klauber, and L.F. Marshall, Outcome from head injury related to patient's age. A longitudinal prospective study of adult and pediatric head injury. J Neurosurg., 1988. 68(3): p. 409-16 [DOI]
8. 8. De Silva, M.J., et al., Patient outcome after traumatic brain injury in high-, middle- and low-income countries: analysis of data on 8927 patients in 46 countries. International Journal of Epidemiology, 2008. 38(2): p. 452-458. [DOI]
9. 9. Hoffman, J.R., et al., Validity of a set of clinical criteria to rule out injury to the cervical spine in patients with blunt trauma. National Emergency X-Radiography Utilization Study Group. N Engl J Med, 2000. 343(2): p. 94-9. [DOI]
10. 10. Kariman, H., et al., Correlation of Ordered Cervical Spine X-rays in Emergency Department with NEXUS and Canadian C-Spine Rules; a Clinical Audit. Emergency medicine journal, 2015. 2(4): p. 150-154. [DOI]
11. 11. Mower, W.R., et al., Developing a clinical decision instrument to rule out intracranial injuries in patients with minor head trauma: Methodology of the NEXUS II investigation. Annals of Emergency Medicine, 2002. 40(5): p. 505-515. [DOI]
12. 12. Ro, Y.S., et al., Comparison of Clinical Performance of Cranial Computed Tomography Rules in Patients With Minor Head Injury: A Multicenter Prospective Study. Academic Emergency Medicine, 2011. 18(6): p. 597-604. [DOI]
13. 13. Papa, L., et al., Performance of the Canadian CT Head Rule and the New Orleans Criteria for predicting any traumatic intracranial injury on computed tomography in a United States Level I trauma center. Academic emergency medicine 2012. 19(1): p. 2-10. [DOI]
14. 14. Jagoda, A.S., et al., Clinical Policy: Neuroimaging and Decisionmaking in Adult Mild Traumatic Brain Injury in the Acute Setting. Annals of Emergency Medicine, 2008. 52(6): p. 714-748. [DOI]
15. 15. Mata-Mbemba, D., et al., Canadian CT head rule and New Orleans Criteria in mild traumatic brain injury: comparison at a tertiary referral hospital in Japan. SpringerPlus, 2016. 5: p. 176-176. [DOI]
16. 16. Harnan, S.E., et al., Clinical Decision Rules for Adults With Minor Head Injury: A Systematic Review. Journal of Trauma and Acute Care Surgery, 2011. 71(1): p. 245-251. [DOI]
17. 17. Mower, W.R., et al., Validation of the sensitivity of the National Emergency X-Radiography Utilization Study (NEXUS) Head computed tomographic (CT) decision instrument for selective imaging of blunt head injury patients: An observational study. PLoS medicine, 2017. 14(7): p. e1002313-e1002313. [DOI]
18. 18. Hsiao, K.Y., et al., An Evaluation of the ACEP Guideline for Mild Head Injuries in Taiwan. Hong Kong Journal of Emergency Medicine, 2017. 24(2): p. 73-78. [DOI]
19. 19. Korley, F.K., et al., Agreement Between Routine Emergency Department Care and Clinical Decision Support Recommended Care in Patients Evaluated for Mild Traumatic Brain Injury. Academic Emergency Medicine, 2013. 20(5): p. 463-469. [DOI]
20. 20. Smits, M., et al., External Validation of the Canadian CT Head Rule and the New Orleans Criteria for CT Scanning in Patients With Minor Head Injury. JAMA, 2005. 294(12): p. 1519-1525. [DOI]
21. 21. Sultan, H.Y., et al., Application of the Canadian CT head rules in managing minor head injuries in a UK emergency department: implications for the implementation of the NICE guidelines. Emergency medicine journal : EMJ, 2004. 21(4): p. 420-425. [DOI]
22. 22. Stiell, I.G., et al., The Canadian CT Head Rule for patients with minor head injury. The Lancet, 2001. 357(9266): p. 1391-1396. [DOI]
23. 23. Mata-Mbemba, D., et al., Early CT Findings to Predict Early Death in Patients with Traumatic Brain Injury: Marshall and Rotterdam CT Scoring Systems Compared in the Major Academic Tertiary Care Hospital in Northeastern Japan. Academic Radiology, 2014. 21(5): p. 605-611. [DOI]
24. 24. Forouzan, A., et al., Head Trauma Patients Presented To Emergency Department; an Epidemiologic Study. Emergency medicine journal, 2015. 2(3): p. 134-138. [DOI]
25. 25. DeAngelis, J., et al., Head CT for Minor Head Injury Presenting to the Emergency Department in the Era of Choosing Wisely. The western journal of emergency medicine. 18(5): p. 821-829. [DOI]
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