Comparative study of the Three Criteria NEXUS II (National Emergency X-Ray Utilization Study) Canadian Computed Tomography Head Rule (CCHR) and American College of Emergency Physicians (ACEP) in the Diagnosis of Minor Head Trauma

Abstract

Background and Objective: Disabilities caused by traumatic brain injuries affect millions of people worldwide, the use of CT scan (CT) is a method for the diagnosis of lesions. The aim of this study was to compare the criteria of sensitivity and specificity in determining the necessity of CT. Materials and Methods: In this cross-sectional study, 100 traumatic patients who referred to the emergency department of Kosar Hospital with head injury were enrolled. On the basis of clinical examination and medical record for each system (ACEP, CCHR, Nexus) related clinical items recorded, and based on which scores were calculated for each. Data were analyzed using descriptive statistics, sensitivity and specificity, Chi-square, ROC curve, SPSS software version 20. Results: Results showed that, in terms of gender, 47 (47%) were male and 53 (53%) were female. The mean age of patients was 46.02 ± 18.20 years. 37% had a head hematoma and 50% had a trauma. The sensitivity and specificity of the three criteria used (ACEP, Nexus and CCHR) were: 29.40% - 62.50%, 13.3% - 96.8% and 38.23% - 71.87%, respectively. Significance was observed between sensitivity and specificity of the three criteria (p <0.001). Conclusion: The results of the sensitivity and specificity of the study were inconsistent with the findings of other studies. The proposed criteria of this study for CT may not have acceptable sensitivity and specificity.

Keywords

• sensitivity
• criteria for clinical decision making
• head minor trauma