NEXUS Chest CT Rule

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

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