The Validity of Canadian Cervical Spine Rules and the Nexus Low Risk Criteria in Trauma Patients
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Tarih
2019
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info:eu-repo/semantics/openAccess
Özet
Background: The first decision rule developed to identify clinically significant injuries in blunt cervicaltrauma patients is National Emergency X-Radiography Utilisation Study (NEXUS). In the NEXUS study, thenegative predictive value (NPV) has been determined as 99.8%. Sensitivity of Canadian Cervical Spine Rules(CCR) was reported as 99.4%, specificity as 45.1% and NPV was reported as 100%. The objective of this studyis to determine the reliability and utility of NEXUS and CCR for Turkish patient population that has a risk ofcervical injury.Methods: This prospective observational study included 225 patients, all stable, conscious patients over 16years of age who had acute trauma and were brought to the hospital with ambulances or using their ownmeans and who had been injured by a mechanism that may cause cervical trauma, and without exclusioncriteria. The patients included in the study were then evaluated for NEXUS and CCR validity.Results: When CCR was evaluated as a whole, it was determined that all pathological cases were identifiedusing these rules. In terms of identifying the presence of pathological imaging finding the sensitivity of CCRwas 100% (95% CI % 56-100) and specificity was 3.2% (95% CI 1.4-6.7%). NEXUS's sensitivity was calculatedas 93% (95% CI 83-97) and specificity as 1.3%(95% CI 0.2-5.1).Conclusion: CCR and the NEXUS were determined to be useful in the emergency department for theexclusion of cervical pathologies. CCR were more reliable and useful when compared with the NEXUS.
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9
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1
