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学术急诊医学档案

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卷 5 编号 1 (2017)

一月 2017

Thoracic Injury Rule out Criteria in Prediction of Traumatic Intra-thoracic Injuries; a Validation Study

  • Setareh Asgarzadeh
  • Bahareh Feizi
  • Farhad Sarabandi
  • Morteza Asgarzadeh

学术急诊医学档案, 卷 5 编号 1 (2017), 1 一月 2017 , 第 e27 页
https://doi.org/10.22037/aaem.v5i1.151 已出版: 2017-01-10

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摘要

Introduction: Doing Chest X Ray (CXR) for all trauma patients is not efficient and cost effective due to its low diagnostic value. The present study was designed aiming to evaluate the diagnostic accuracy of thoracic injury rule out criteria (TIRC) in prediction of traumatic intra-thoracic injuries and need for CXR. Method: The present study is a prospective cross-sectional study that has been carried out to evaluate the accuracy of TIRC model in screening blunt multiple trauma patients in need of CXR for ruling out intra-thoracic injuries. Results: 1518 patients with the mean age of 33.53 ± 15.42 years were enrolled (80.4% male). The most common mechanisms of trauma were motor car accident (78.8%) and falling (13.6%). Area under the ROC curve, sensitivity, and specificity of model in detection of traumatic thoracic injuries was 0.95 (95% CI: 0.93 – 0.97), 100 (95% CI: 87.0 – 100), and 80.1 (95% CI: 78.0 – 82.1), respectively. Brier score for TIRC was 0.02 and its scaled reliability was 0.0002. Conclusion: Findings of the present study showed that TIRC has high accuracy in prediction of traumatic intra-thoracic injuries and screening patients in need of CXR.
关键词:
  • Thoracic injuries
  • decision support techniques
  • mass chest x-ray
  • diagnosis
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Asgarzadeh S, Feizi B, Sarabandi F, Asgarzadeh M. Thoracic Injury Rule out Criteria in Prediction of Traumatic Intra-thoracic Injuries; a Validation Study. Arch Acad Emerg Med [网际网络]. 2017年1月10日 [见引于 2026年7月7日];5(1):e27. 载于: https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/151
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参考

Katsuura Y, Osborn JM, Cason GW. The epidemiology of thoracolumbar trauma: A meta-analysis. Journal of orthopaedics. 2016;13(4):383-8.

Heron M. Deaths: leading causes for 2008. National Vital Statistics Reports: From the Centers for Disease Control and Prevention, National Center for Health Statistics, National Vital Statistics System. 2012;60(6):1-94.

Rahimi-Movaghar V, Yousefifard M, Ghelichkhani P, Baikpour M, Tafakhori A, Asady H, et al. Application of Ultrasonography and Radiography in Detection of Hemothorax: a Systematic Review and Meta-Analysis. EMERGENCY-An Academic Emergency Medicine Journal. 2016;4(3):116-26.

Exadaktylos AK, Sclabas G, Schmid SW, Schaller B, Zimmermann H. Do we really need routine computed tomographic scanning in the primary evaluation of blunt chest trauma in patients with "normal" chest radiograph? The Journal of trauma. 2001;51(6):1173-6.

Sears BW, Luchette FA, Esposito TJ, Dickson EL, Grant M, Santaniello JM, et al. Old fashion clinical judgment in the era of protocols: is mandatory chest X-ray necessary in injured patients? The Journal of trauma. 2005;59(2):324-30; discussion 30-2.

Rodriguez RM, Anglin D, Langdorf MI, Baumann BM, Hendey GW, Bradley RN, et al. NEXUS chest: validation of a decision instrument for selective chest imaging in blunt trauma. JAMA surgery. 2013;148(10):940-6.

Forouzanfar MM, Safari S, Niazazari M, Baratloo A, Hashemi B, Hatamabadi HR, et al. Clinical decision rule to prevent unnecessary chest X-ray in patients with blunt multiple traumas. Emergency medicine Australasia : EMA. 2014;26(6):561-6.

Hoffman JR, Mower WR, Wolfson AB, Todd KH, Zucker MI. 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. The New England journal of medicine. 2000;343(2):94-9.

Bouwmeester W, Zuithoff NP, Mallett S, Geerlings MI, Vergouwe Y, Steyerberg EW, et al. Reporting and methods in clinical prediction research: a systematic review. PLoS medicine. 2012;9(5):1-12.

Cook NR. Statistical evaluation of prognostic versus diagnostic models: beyond the ROC curve. Clinical chemistry. 2008;54(1):17-23.

Safari S, Yousefifard M, Baikpour M, Rahimi-Movaghar V, Abiri S, Falaki M, et al. Validation of thoracic injury rule out criteria as a decision instrument for screening of chest radiography in blunt thoracic trauma. Journal of clinical orthopaedics and trauma. 2016;7(2):95-100.

Rodriguez RM, Anglin D, Langdorf MI, et al. Nexus chest: Validation of a decision instrument for selective chest imaging in blunt trauma. JAMA surgery. 2013;148(10):940-6.

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