作者
Ian G Stiell, Catherine M Clement, R Douglas McKnight, Robert Brison, Michael J Schull, Brian H Rowe, James R Worthington, Mary A Eisenhauer, Daniel Cass, Gary Greenberg, Iain MacPhail, Jonathan Dreyer, Jacques S Lee, Glen Bandiera, Mark Reardon, Brian Holroyd, Howard Lesiuk, George A Wells
发表日期
2003/12/25
期刊
New England Journal of Medicine
卷号
349
期号
26
页码范围
2510-2518
出版商
Massachusetts Medical Society
简介
Background
The Canadian C-Spine (cervical-spine) Rule (CCR) and the National Emergency X-Radiography Utilization Study (NEXUS) Low-Risk Criteria (NLC) are decision rules to guide the use of cervical-spine radiography in patients with trauma. It is unclear how the two decision rules compare in terms of clinical performance.
Methods
We conducted a prospective cohort study in nine Canadian emergency departments comparing the CCR and NLC as applied to alert patients with trauma who were in stable condition. The CCR and NLC were interpreted by 394 physicians for patients before radiography.
Results
Among the 8283 patients, 169 (2.0 percent) had clinically important cervical-spine injuries. In 845 (10.2 percent) of the patients, physicians did not evaluate range of motion as required by the CCR algorithm. In analyses that excluded these indeterminate cases, the CCR was more sensitive than the …
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IG Stiell, CM Clement, RD McKnight, R Brison… - New England Journal of Medicine, 2003