Difference between revisions of "NEXUS Chest CT Rule"

(See Also)
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*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==
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''May not need a CT if all criteria are absent''
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{{Nexus chest CT in trauma major rule}}
#Abnormal CXR
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#Distracting injury
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{{Nexus chest CT in trauma minor rule}}
#Chest wall tenderness
 
#Sternum tenderness
 
#Thoracic spine tenderness
 
#Scapula tenderness
 
 
==CT All Injuries Rule==
 
==CT All Injuries Rule==
 
''May not need a CT if all criteria are absent''
 
''May not need a CT if all criteria are absent''

Revision as of 12:33, 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


Nexus chest CT in trauma rule (major injury)

CT if any one of the following:

  • Abnormal CXR
  • Distracting injury
  • Tenderness of:
    • Chest wall
    • Sternum
    • Thoracic spine
    • Scapula

Sensitivity

  • 99% for major injuries
  • 90% for minor injuries

Nexus chest CT in trauma rule (minor injury)

CT if any one of the following:

  • Abnormal CXR
  • Distracting injury
  • Tenderness of:
    • Chest wall
    • Sternum
    • Thoracic spine
    • Scapula
  • Rapid deceleration mechanism

Sensitivity

  • 99% for major injuries
  • 95% for minor injuries

CT All Injuries Rule

May not need a CT if all criteria are absent

  1. Abnormal CXR
  2. Distracting injury
  3. Chest wall tenderness
  4. Sternum tenderness
  5. Thoracic spine tenderness
  6. Scapula tenderness
  7. 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.

See Also

External Links

References

  1. 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.full text