Prediction Value of the Canadian CT Head Rule and the New Orleans Criteria for Positive Head CT Scan and Acute Neurosurgical Procedures in Minor Head Trauma: A Multicenter External Validation Study

Bouida, Wahid; Marghli, Soudani; Souissi, Sami; Ksibi, Hichem; Methammem, Mehdi; Haguiga, Habib; Khedher, Sonia; Boubaker, Hamdi; Beltaïef, Kaouthar; Grissa, Mohamed Habib; Trimech, Mohamed Naceur; Kerkeni, W.; Chebili, Naoufel; Halila, Imen; Rejeb, Imen; Boukef, Riadh; Rekik, Noureddine; Bouhaja, B; Letaief, Mondher; Nouira, Semir

doi:10.1016/j.annemergmed.2012.07.016

Cited by 88 publications

(66 citation statements)

References 15 publications

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“…The major mechanism of injury in our study was fall from the same level (50.5% in CCHR group and 49.4% in NOC group), whilst the mechanism of injury was relatively more equally distributed in other overseas validation studies. 3,6,8 This could have produced a spectrum effect to affect the sensitivity and specificity of both clinical rules in our study.…”

Section: -14mentioning

confidence: 99%

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A Retrospective Study of Patients with Minor Head Injury to Compare the Canadian CT Head Rule and the New Orleans Criteria

Lo¹,

Shih²,

Leung³

et al. 2016

Hong Kong Journal of Emergency Medicine

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Objective:To compare the performance of the Canadian CT Head Rule (CCHR) and the New Orleans Criteria (NOC) in minor head injury patients. Method: This retrospective cohort study collected data and CT head reports of all minor head injury patients from 1 January 2008 to 31 December 2010. We compared the sensitivity, specificity, positive and negative predictive values of both rules in predicting clinically important brain injury on CT and the need of neurosurgical intervention. Results: We reviewed 474 patients with minor head injury. Seventy seven patients had clinically important brain injury and 11 underwent neurosurgical intervention. The sensitivity of the CCHR and NOC in predicting clinically important brain injury were 80% (95% confidence interval [CI] 70-88%) and 92% (95% CI 86-98%), respectively; and the specificity of the CCHR and NOC were 39% (95% CI 33-44%) and 17% (95% CI 13-21%), respectively. The sensitivity of the CCHR and NOC in predicting the need of neurosurgical intervention were 80% (95% CI 55-100%) and 100% (95% CI 100-100%), respectively; and the specificity of the CCHR and NOC were 36% (95% CI 31-41%) and 15% (95% CI 12-19%), respectively. The negative predictive values (NPV) of the CCHR and NOC for clinically important brain injury were 88% (95%CI 83-94%) and 91% (95%CI 84-98%); and for the need of neurosurgical intervention were 99 %( 95% CI 96-100%) and 100% (95% CI 100-100%). Amongst those missed cases, 88% in the CCHR group and 83% in the NOC group reported loss of consciousness. Conclusions: The NOC is more sensitive but less specific than the CCHR in predicting both outcomes. Both rules have excellent NPV to rule out the need of neurosurgical intervention. (Hong Kong j.emerg.med. 2016;23:25-33)

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Section: -14mentioning

confidence: 99%

“…8 Some demonstrated equal sensitivity of both clinical rules in predicting clinically important brain injury. 5,6,9 We propose that loss of consciousness is a statistically important clinical predictor of both clinically important brain injury and the need of neurosurgical intervention, which agrees with many previous studies.…”

Section: -14mentioning

confidence: 99%

A Retrospective Study of Patients with Minor Head Injury to Compare the Canadian CT Head Rule and the New Orleans Criteria

Lo¹,

Shih²,

Leung³

et al. 2016

Hong Kong Journal of Emergency Medicine

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“…28 These patients may not always present with the typical symptoms of mTBI but may nevertheless suffer significant consequences. 29,30 An extensive review of the literature was conducted in order to find an appropriate definition of minor head trauma without brain injury. Some authors have suggested the term "minimal traumatic head injury" to define a head trauma with a GCS score of 15 without any brain injury (i.e.…”

Section: Discussionmentioning

confidence: 99%

Comparison of functional outcomes in elderly who have sustained a minor trauma with or without head injury: a prospective multicenter cohort study

Brousseau

Émond

Sirois

et al. 2016

CJEM

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Objectives: The consequences of minor trauma involving a head injury (MT-HI) in independent older adults are largely unknown. This study assessed the impact of a head injury on the functional outcomes six months post-injury in older adults who sustained a minor trauma. Methods: This multicenter prospective cohort study in eight sites included patients who were aged 65 years or older, previously independent, presenting to the emergency department (ED) for a minor trauma, and discharged within 48 hours. To assess the functional decline, we used a validated test: the Older Americans' Resources and Services Scale. The cognitive function of study patients was also evaluated. Finally, we explored the influence of a concomitant injury on the functional decline in the MT-HI group. Results: All 926 eligible patients were included in the analyses: 344 MT-HI patients and 582 minor trauma without head injury. After six months, the functional decline was similar in both groups: 10.8% and 11.9%, respectively (RR = 0.79 [95% CI: 0.55-1.14]). The proportion of patients with mild cognitive disabilities was also similar: 21.7% and 22.8%, respectively (RR = 0.91 [95% CI: 0.71-1.18]). Furthermore, for the group of patients with a MT-HI, the functional outcome was not statistically different with or without the presence of a co-injury (RR = 1.35 [95% CI: 0.71-2.59]). Conclusion:This study did not demonstrate that the occurrence of a MT-HI is associated with a worse functional or cognitive prognosis than other minor injuries without a head injury in an elderly population, six months after injury. RÉSUMÉObjectifs : Les conséquences d'un traumatisme mineur impliquant une blessure à la tête dans la population gériatrique autonome sont largement inconnues. Cette étude en a évalué l'impact en termes de conséquences fonctionnelles six mois après le trauma. Méthodes : Pour être inclus dans cette cohorte prospective multicentrique de huit sites différents, les patients devaient : être âgés de 65 ans ou plus, être autonomes avant la blessure, avoir consulté au département d'urgence pour un traumatisme mineur et avoir été libérés de l'hôpital dans les 48 heures. Pour évaluer le déclin fonctionnel, un test validé a été utilisé : l'échelle Older Americans' Resources and Services. La fonction cognitive a également été mesurée. Finalement, nous avons exploré l'influence d'une blessure concomitante sur le déclin fonctionnel dans le groupe de patients ayant subi un trauma mineur à la tête. Résultats : Les 926 patients éligibles ont été inclus dans les analyses: 344 patients avec trauma à la tête et 582 traumas mineurs sans trauma à la tête. Après six mois, le déclin fonctionnel était similaire dans les deux groupes, 10,8% et 11,9% respectivement (RR = 0,79 [IC 95%: 0,55 à 1,14]). Conclusion : Dans une population âgée autonome, la survenue d'un traumatisme à la tête ne semble pas être associée à un moins bon pronostic fonctionnel ou cognitif six mois plus tard, comparativement aux traumas mineurs sans blessure à la tête.

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“…Using studies from emergency/trauma literature can aid in determining the need for further imaging. Several clinical decision rules (Canadian CT Rules, New Orleans Criteria and National Emergency X-Radiography Utilization Study (Nexus II)) have been developed by studying emergency room patients [24,25]. These rules in general apply only to those patients >16 years old.…”

Section: Head and Neckmentioning

confidence: 99%

Evaluation and treatment of trauma related collapse in athletes

Gammons

2014

Curr Rev Musculoskelet Med

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Although blunt traumatic injuries are common in athletes, life-threatening trauma is fortunately rare. Most current literature has focused on nontraumatic causes of athlete death though traumatic injuries may be more common. Although prevention of these injuries may be more difficult than nontraumatic causes, prompt recognition and treatment is paramount. Common traumatic causes of collapse athlete generally involve the head, neck, and trunk and are more frequent in collision sports. Other higher risk sports include track and field, cheerleading, snow sports, and those involving motorized vehicles. Health care providers who participate in sports coverage should be aware of the potential for these injuries as emergency treatment is required to maximize outcomes. Emergency action plans allow providers to expediently activate emergency management services while providing treatment and stabilization.

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Prediction Value of the Canadian CT Head Rule and the New Orleans Criteria for Positive Head CT Scan and Acute Neurosurgical Procedures in Minor Head Trauma: A Multicenter External Validation Study

Cited by 88 publications

References 15 publications

A Retrospective Study of Patients with Minor Head Injury to Compare the Canadian CT Head Rule and the New Orleans Criteria

A Retrospective Study of Patients with Minor Head Injury to Compare the Canadian CT Head Rule and the New Orleans Criteria

Comparison of functional outcomes in elderly who have sustained a minor trauma with or without head injury: a prospective multicenter cohort study

Evaluation and treatment of trauma related collapse in athletes

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