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Efficacy of Canadian computed tomography head rule in predicting the need for a computed–axial tomography scans among patients with suspected head injuries

CONTEXT: The use of imaging modalities is crucial in the diagnostic field of critical medicine. However, the ethical and economic use of these techniques has become a major concern especially in resource-poor settings. The Canadian computed tomography Head Rule (CCHR) is being increasingly used all...

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Autores principales: Anish, Thekkumkara Surendran Nair, Sreelakshmi, Pallipurathu Reghunathan Nair, Medhavan, Sarath, Babu, Shahid, Sugathan, Sambu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3500009/
https://www.ncbi.nlm.nih.gov/pubmed/23181211
http://dx.doi.org/10.4103/2229-5151.100904
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author Anish, Thekkumkara Surendran Nair
Sreelakshmi, Pallipurathu Reghunathan Nair
Medhavan, Sarath
Babu, Shahid
Sugathan, Sambu
author_facet Anish, Thekkumkara Surendran Nair
Sreelakshmi, Pallipurathu Reghunathan Nair
Medhavan, Sarath
Babu, Shahid
Sugathan, Sambu
author_sort Anish, Thekkumkara Surendran Nair
collection PubMed
description CONTEXT: The use of imaging modalities is crucial in the diagnostic field of critical medicine. However, the ethical and economic use of these techniques has become a major concern especially in resource-poor settings. The Canadian computed tomography Head Rule (CCHR) is being increasingly used all over the world to evaluate the necessity of a Computer-assisted Tomography (CT) scan in patients with suspected head injury. AIM: The aim of the current study is to evaluate the efficacy of CCHR to predict the occurrence of head injury, as evidenced radiologically by a CT Head, at a government tertiary care clinical setting in south India. SETTING AND DESIGN: The design was that of a hospital-based cross-sectional survey conducted at the Medical College Hospital, Thiruvananthapuram (Kerala, India). MATERIALS AND METHODS: The study subjects were patients with suspected head injury evaluated at the Surgical Casualty Department of the study setting. Fifty consecutive patients with suspected head injury were enrolled in the study. STATISTICAL ANALYSIS: The Chi-square test was used to assess the statistical significance of association between the outcome variable and the exposure characteristics. The diagnostic ability of the Glasgow Coma Scale (GCS) and CCHR were expressed in terms of sensitivity and specificity by considering CT diagnosed Head injury as the gold standard diagnostic tool. RESULTS: Clinical manifestations as measured by a GCS score < 13 failed to significantly predict a head injury in the CT scan. However, the same became statistically significant when the CCHR was added to the GCS score as a predictor (P value < 0.001). The sensitivity of the tool in predicting a head injury rose from 23.3 to 96.7%. CONCLUSION: The current study suggested that the CCHR could act as an excellent decision rule to indicate the need of a CT scan. The need of a decision rule was warranted in the context of the growth of newer diagnostic imaging facilities in India.
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spelling pubmed-35000092012-11-23 Efficacy of Canadian computed tomography head rule in predicting the need for a computed–axial tomography scans among patients with suspected head injuries Anish, Thekkumkara Surendran Nair Sreelakshmi, Pallipurathu Reghunathan Nair Medhavan, Sarath Babu, Shahid Sugathan, Sambu Int J Crit Illn Inj Sci Original Article CONTEXT: The use of imaging modalities is crucial in the diagnostic field of critical medicine. However, the ethical and economic use of these techniques has become a major concern especially in resource-poor settings. The Canadian computed tomography Head Rule (CCHR) is being increasingly used all over the world to evaluate the necessity of a Computer-assisted Tomography (CT) scan in patients with suspected head injury. AIM: The aim of the current study is to evaluate the efficacy of CCHR to predict the occurrence of head injury, as evidenced radiologically by a CT Head, at a government tertiary care clinical setting in south India. SETTING AND DESIGN: The design was that of a hospital-based cross-sectional survey conducted at the Medical College Hospital, Thiruvananthapuram (Kerala, India). MATERIALS AND METHODS: The study subjects were patients with suspected head injury evaluated at the Surgical Casualty Department of the study setting. Fifty consecutive patients with suspected head injury were enrolled in the study. STATISTICAL ANALYSIS: The Chi-square test was used to assess the statistical significance of association between the outcome variable and the exposure characteristics. The diagnostic ability of the Glasgow Coma Scale (GCS) and CCHR were expressed in terms of sensitivity and specificity by considering CT diagnosed Head injury as the gold standard diagnostic tool. RESULTS: Clinical manifestations as measured by a GCS score < 13 failed to significantly predict a head injury in the CT scan. However, the same became statistically significant when the CCHR was added to the GCS score as a predictor (P value < 0.001). The sensitivity of the tool in predicting a head injury rose from 23.3 to 96.7%. CONCLUSION: The current study suggested that the CCHR could act as an excellent decision rule to indicate the need of a CT scan. The need of a decision rule was warranted in the context of the growth of newer diagnostic imaging facilities in India. Medknow Publications & Media Pvt Ltd 2012 /pmc/articles/PMC3500009/ /pubmed/23181211 http://dx.doi.org/10.4103/2229-5151.100904 Text en Copyright: © International Journal of Critical Illness and Injury Science http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Anish, Thekkumkara Surendran Nair
Sreelakshmi, Pallipurathu Reghunathan Nair
Medhavan, Sarath
Babu, Shahid
Sugathan, Sambu
Efficacy of Canadian computed tomography head rule in predicting the need for a computed–axial tomography scans among patients with suspected head injuries
title Efficacy of Canadian computed tomography head rule in predicting the need for a computed–axial tomography scans among patients with suspected head injuries
title_full Efficacy of Canadian computed tomography head rule in predicting the need for a computed–axial tomography scans among patients with suspected head injuries
title_fullStr Efficacy of Canadian computed tomography head rule in predicting the need for a computed–axial tomography scans among patients with suspected head injuries
title_full_unstemmed Efficacy of Canadian computed tomography head rule in predicting the need for a computed–axial tomography scans among patients with suspected head injuries
title_short Efficacy of Canadian computed tomography head rule in predicting the need for a computed–axial tomography scans among patients with suspected head injuries
title_sort efficacy of canadian computed tomography head rule in predicting the need for a computed–axial tomography scans among patients with suspected head injuries
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3500009/
https://www.ncbi.nlm.nih.gov/pubmed/23181211
http://dx.doi.org/10.4103/2229-5151.100904
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