Dataset Information

Anterior-posterior view by full-body digital X-ray to rule out severe spinal injuries in Polytraumatized patients.

ABSTRACT:

Background

Spinal injuries are present in 16-31% of polytraumatized patients. Rapid identification of spinal injuries requiring immobilization or operative treatment is essential. The Lodox-Statscan (LS) has evolved into a promising time-saving diagnostic tool to diagnose life-threatening injuries with an anterior-posterior (AP)-full-body digital X-ray.

Methods

We aimed to analyze the diagnostic accuracy and the interrater reliability of AP-LS to detect spinal injuries in polytraumatized patients. Therefore, within 3 years, AP-LS of polytraumatized patients (ISS ≥ 16) were retrospectively analyzed by three independent observers. The sensitivity and specificity of correct diagnosis with AP-LS compared to CT scan were calculated. The diagnostic accuracy was evaluated by using the area under the ROC (receiver operating characteristic curve) for sensitivity and specificity. Interrater reliability between the three observers was calculated using Fleiss' Kappa. The sensitivity of AP-LS was further analyzed by the severity of spinal injuries.

Results

The study group included 320 patients (48.5 years ±19.5, 89 women). On CT scan, 207 patients presented with a spinal injury (65%, total of 332 injuries). AP-LS had a low sensitivity of 9% (31 of 332, range 0-24%) and high specificity of 99% (range 98-100%). The sensitivity was highest for thoracic spinal injuries (14%). The interrater reliability was slight (κ = 0.02; 95% CI: 0.00, 0.03). Potentially unstable spinal injuries were more likely to be detected than stable injuries (sensitivity 18 and 6%, respectively).

Conclusion

This study demonstrated high specificity with low sensitivity of AP-LS in detecting spinal injuries compared to CT scan. In polytraumatized patients, AP-LS, implemented in the Advanced Trauma Life Support-algorithm, is a helpful tool to diagnose life-threatening injuries. However, if spinal injuries are suspected, performing a full-body CT scan is necessary for correct diagnosis.

SUBMITTER: Hackel S

PROVIDER: S-EPMC7934441 | biostudies-literature | 2021 Mar

REPOSITORIES: biostudies-literature

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Publications

Anterior-posterior view by full-body digital X-ray to rule out severe spinal injuries in Polytraumatized patients.

Häckel Sonja S Hofmann Elena E Anwander Helen H Albers Christoph E CE Basedow Jasmin J Bigdon Sebastian F SF Exadaktylos Aristomenis K AK Keel Marius J B MJB Dunn Robert N RN Maqungo Sithombo S Benneker Lorin M LM Held Michael M Hoppe Sven S

BMC emergency medicine 20210305 1

<h4>Background</h4>Spinal injuries are present in 16-31% of polytraumatized patients. Rapid identification of spinal injuries requiring immobilization or operative treatment is essential. The Lodox-Statscan (LS) has evolved into a promising time-saving diagnostic tool to diagnose life-threatening injuries with an anterior-posterior (AP)-full-body digital X-ray.<h4>Methods</h4>We aimed to analyze the diagnostic accuracy and the interrater reliability of AP-LS to detect spinal injuries in polytrau ...[more]

PMID: 33663394

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Dataset Information

Anterior-posterior view by full-body digital X-ray to rule out severe spinal injuries in Polytraumatized patients.

Background

Methods

Results

Conclusion

Publications

Anterior-posterior view by full-body digital X-ray to rule out severe spinal injuries in Polytraumatized patients.

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