ArticleJournal of neurology, neurosurgery, and psychiatry2004
Prospective validation of a proposal for diagnosis and management of patients attending the emergency department for mild head injury.
Article in Journal of neurology, neurosurgery, and psychiatry, 2004. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
- Medical outcome after immediate computed tomography or admission for observation in patients with mild head injury: randomised controlled trial.BMJ (Clinical research ed.) · 2006Trial
- Frequency and clinical features of radiographic head injury caused by inpatient falls: a single-centre retrospective cohort study.BMJ open · 2023Article
- tbiExtractor: A framework for extracting traumatic brain injury common data elements from radiology reports.PloS one · 2020Article
- Evaluation of Clinical Criteria for Performing Brain CT-Scan in Patients with Mild Traumatic Brain Injury; A New Diagnostic Probe.Bulletin of emergency and trauma · 2019Article
- Mild brain injury and anticoagulants: Less is enough.Neurology. Clinical practice · 2017Article
- Head CT scan in Iranian minor head injury patients: evaluating current decision rules.Emergency radiology · 2016Article
- Canadian CT head rule and New Orleans Criteria in mild traumatic brain injury: comparison at a tertiary referral hospital in Japan.SpringerPlus · 2016Article
- Antiplatelet therapy and the outcome of subjects with intracranial injury: the Italian SIMEU study.Critical care (London, England) · 2013Observational
- Predictors of positive head CT scan and neurosurgical procedures after minor head trauma.The Journal of surgical research · 2012Article
- Mild traumatic brain injury: part 1: determining the need to scan.Canadian family physician Medecin de famille canadien · 2010Article
- The economic impact of S-100B as a pre-head CT screening test on emergency department management of adult patients with mild traumatic brain injury.Journal of neurotrauma · 2009Article
- [Mild head injury: diagnostic pitfalls and complications].Der Unfallchirurg · 2008Review
- Outcome after complicated minor head injury.AJNR. American journal of neuroradiology · 2008Article
- Emergency department management of mild traumatic brain injury in the USA.Emergency medicine journal : EMJ · 2005Article
- Transcranial Doppler to detect on admission patients at risk for neurological deterioration following mild and moderate brain trauma.Intensive care medicine · 2005Article
- Mild head injury: reliability of early computed tomographic findings in triage for admission.Emergency medicine journal : EMJ · 2005Review
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn mild head injury, predictors to select patients for computed tomography (CT) and/or to plan proper management are needed. The strength of evidence of published recommendations is insufficient for current use. We assessed the diagnostic accuracy and the clinical validity of the proposal of the Neurotraumatology Committee of the World Federation of Neurosurgical Societies on mild head injury from an emergency department perspective.
methodsIn a three year period, 5578 adolescent and adult subjects were prospectively recruited and managed according to the proposed protocol. Outcome measures were: (a) any post-traumatic lesion; (b) need for neurosurgical intervention; (c) unfavourable outcome (death, permanent vegetative state or severe disability) after six months. The predictive value of a model based on five variables (Glasgow coma score, clinical findings, risk factors, neurological deficits, and skull fracture) was tested by logistic regression analysis.
findingsAt first CT evaluation 327 patients (5.9%) had intracranial post-traumatic lesions. In 16 cases (0.3%) previously undiagnosed lesions were detected after re-evaluation within seven days. Neurosurgical intervention was needed in 71 patients (1.3%) and an unfavourable outcome occurred in 39 cases (0.7%). The area under the ROC curve of the variables in predicting post-traumatic lesions was 0.906 (0.009) (sensitivity 70.0%, specificity 94.1% at best cut off), neurosurgical intervention was 0.926 (0.016) (sensitivity 81.7%, specificity 94.1%), and unfavourable outcome was 0.953 (0.014) (sensitivity 88.1%, specificity 95.1%).
interpretationThe variables prove highly accurate in the prediction of clinically meaningful outcomes, when applied to a consecutive set of patients with mild head injury in the clinical setting of a 1st level emergency department.
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