NEXUS Chest CT Rule: Difference between revisions
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==Background== | ==Background== | ||
*8 United States level 1 trauma centers enrolled patients for derivation and validation of a decision instrument to aid in the decision to perform a chest CT in patients with | *8 United States level 1 trauma centers enrolled patients for derivation and validation of a decision instrument to aid in the decision to perform a chest CT in patients with blunt trauma.<ref>Rodriguez, RM et al. Derivation and validation of two decision instruments for selective chest CT in blunt trauma: a multicenter prospective observational study (NEXUS Chest CT). PLoS Med. 2015 Oct 6;12(10):e1001883.[http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001883 full text]</ref> | ||
*The rule has two sub-rules, one for detection of major injuries, and one for detection of all injuries (major and minor injuries) in hemodynamically stable, non-intubated patients | *The rule has two sub-rules, one for detection of major injuries, and one for detection of all injuries (major and minor injuries) in hemodynamically stable, non-intubated patients | ||
==CT Major Injury Rule== | ==CT Major Injury Rule== | ||
''May not need a CT if all criteria are absent'' | ''May not need a CT if all criteria are absent'' | ||
Revision as of 12:29, 11 May 2016
Background
- 8 United States level 1 trauma centers enrolled patients for derivation and validation of a decision instrument to aid in the decision to perform a chest CT in patients with blunt trauma.[1]
- The rule has two sub-rules, one for detection of major injuries, and one for detection of all injuries (major and minor injuries) in hemodynamically stable, non-intubated patients
CT Major Injury Rule
May not need a CT if all criteria are absent
- Abnormal CXR
- Distracting injury
- Chest wall tenderness
- Sternum tenderness
- Thoracic spine tenderness
- Scapula tenderness
CT All Injuries Rule
May not need a CT if all criteria are absent
- Abnormal CXR
- Distracting injury
- Chest wall tenderness
- Sternum tenderness
- Thoracic spine tenderness
- Scapula tenderness
- Rapid deceleration mechanism
Sensitivity
CT-Major Injury Rule
- 99 sensitive for major injuries
- 90% sensitive for minor injuries
CT-All Injury Rule
- 99% sensitive for major injuries
- 95% sensitive for minor injuries.