ArticleInternational journal of critical illness and injury science
Variability of radiological grading of blunt cerebrovascular injuries in trauma patients.
Article in International journal of critical illness and injury science. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- The effect of circle of willis anatomy and scanning practices on outcomes for blunt cerebrovascular injuries.Scandinavian journal of trauma, resuscitation and emergency medicine · 2024Article
- Risk Factors for Cerebral Infarction After Moderate or Severe Traumatic Brain Injury.Therapeutics and clinical risk management · 2021Article
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Authors and funding
10 authors.
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Abstract
contextBlunt cerebrovascular injury (BCVI) occurs in 1%-2% of all blunt trauma patients. Computed tomographic angiography of the neck (CTAn) is commonly used for the diagnosis and grading of BCVIs. Grade of injury dictates treatment, and there remains a lack in understanding the inter-reader reliability of these interpretations.
aimsThe aim of this study is to determine the extent of variability in BCVIs among specialized neuroradiologist interpretation of CTAn. SETTINGS AND
designRetrospective review of trauma patients admitted to a level one trauma center with a BCVI from January 2012 to December 2017. Patients were randomly assigned for CTAn re-evaluation by two of three blinded, neuroradiologists. STATISTICAL ANALYSIS USED: The variability in BCVI grades was measured using the coefficient of unalikeability (u), and inter-reader reliability was calculated using weighted Cohen's kappa (k).
resultsTwo hundred and twenty-eight BCVIs were analyzed with initial grades of 71 (31%) grade one, 74 (32%) grade two, 26 (11%) grade three, 57 (25%) grade four, and 0 grade five. Variability was present in 93 (41%) of all BCVIs. Grade one injuries had the lowest occurrence of total agreement (31%) followed by grade three (61%), grade two (63%), and grade four (92%). Total variability of grade interpretations (u = 100) occurred most frequently with grade three BCVIs (21%). Weighted Cohen's k calculations had a mean of 0.07, indicating poor reader agreement.
conclusionsThis novel study demonstrated the BCVI variability of radiological grade interpretation occurs in more than a third of patients. The reliability of CTAn interpretation of BCVI grades is not uniform, potentially leading to undertreatment and overtreatment.
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