Comparison of the Canadian CT Head Rule and the New Orleans Criteria in patients with minor head injury
Comparison of the Canadian CT Head Rule and the New Orleans Criteria in patients with minor head injury
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DOI：
10.1001/jama.294.12.1511
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发表时间：
2005-09-28
影响因子：
120.7
通讯作者：
Wells, GA
中科院分区：
文献类型：
--
作者：
Stiell, IG;Clement, CM;Wells, GA
Context Current use of cranial computed tomography (CT) for minor head injury is increasing rapidly, highly variable, and inefficient. The Canadian CT Head Rule (CCHR) and New Orleans Criteria (NOC) are previously developed clinical decision rules to guide CT use for patients with minor head injury and with Glasgow Coma Scale (GCS) scores of 13 to 15 for the CCHR and a score of 15 for the NOC. However, uncertainty about the clinical performance of these rules exists.Objective To compare the clinical performance of these 2 decision rules for detecting the need for neurosurgical intervention and clinically important brain injury.Design, Setting, and Patients In a prospective cohort study (June 2000-December 2002) that included 9 emergency departments in large Canadian community and university hospitals, the CCHR was evaluated in a convenience sample of 2707 adults who presented to the emergency department with blunt head trauma resulting in witnessed loss of consciousness, disorientation, or definite amnesia and a GCS score of 13 to 15. The CCHR and NOC were compared in a subgroup of 1822 adults with minor head injury and GCS score of 15. 1Main Outcome Measures Neurosurgical intervention and clinically important brain injury evaluated by CT and a structured follow-up telephone interview.Results Among 1822 patients with GCS score of 15, 8 (0.4%) required neurosurgical intervention and 97 (5.3%) had clinically important brain injury. The NOC and the CCHR both had 100% sensitivity but the CCHR was more specific (76.3% vs 12.1 %, P
