Literature DB >> 18557998

Does applying the Canadian Cervical Spine rule reduce cervical spine radiography rates in alert patients with blunt trauma to the neck? A retrospective analysis.

Ulfin Rethnam1, Rajam Yesupalan, Giri Gandham.   

Abstract

BACKGROUND: A cautious outlook towards neck injuries has been the norm to avoid missing cervical spine injuries. Consequently there has been an increased use of cervical spine radiography. The Canadian Cervical Spine rule was proposed to reduce unnecessary use of cervical spine radiography in alert and stable patients. Our aim was to see whether applying the Canadian Cervical Spine rule reduced the need for cervical spine radiography without missing significant cervical spine injuries.
METHODS: This was a retrospective study conducted in 2 hospitals. 114 alert and stable patients who had cervical spine radiographs for suspected neck injuries were included in the study. Data on patient demographics, high risk & low risk factors as per the Canadian Cervical Spine rule and cervical spine radiography results were collected and analysed.
RESULTS: 28 patients were included in the high risk category according to the Canadian Cervical Spine rule. 86 patients fell into the low risk category. If the Canadian Cervical Spine rule was applied, there would have been a significant reduction in cervical spine radiographs as 86/114 patients (75.4%) would not have needed cervical spine radiograph. 2/114 patients who had significant cervical spine injuries would have been identified when the Canadian Cervical Spine rule was applied.
CONCLUSION: Applying the Canadian Cervical Spine rule for neck injuries in alert and stable patients would have reduced the use of cervical spine radiographs without missing out significant cervical spine injuries. This relates to reduction in radiation exposure to patients and health care costs.

Entities:  

Mesh:

Year:  2008        PMID: 18557998      PMCID: PMC2442046          DOI: 10.1186/1471-2342-8-12

Source DB:  PubMed          Journal:  BMC Med Imaging        ISSN: 1471-2342            Impact factor:   1.930


  11 in total

1.  Implementation of the Canadian C-spine rule reduces cervical spine x-ray rate for alert patients with potential neck injury.

Authors:  Debra Kerr; Luke Bradshaw; Anne-Maree Kelly
Journal:  J Emerg Med       Date:  2005-02       Impact factor: 1.484

2.  Cervical spine injury and radiography in alert, high-risk patients.

Authors:  R M McNamara; E Heine; B Esposito
Journal:  J Emerg Med       Date:  1990 Mar-Apr       Impact factor: 1.484

Review 3.  Radiographic decision-making by the emergency physician.

Authors:  A E Long
Journal:  Emerg Med Clin North Am       Date:  1985-08       Impact factor: 2.264

4.  The Canadian C-spine rule for radiography in alert and stable trauma patients.

Authors:  I G Stiell; G A Wells; K L Vandemheen; C M Clement; H Lesiuk; V J De Maio; A Laupacis; M Schull; R D McKnight; R Verbeek; R Brison; D Cass; J Dreyer; M A Eisenhauer; G H Greenberg; I MacPhail; L Morrison; M Reardon; J Worthington
Journal:  JAMA       Date:  2001-10-17       Impact factor: 56.272

5.  The etiology of missed cervical spine injuries.

Authors:  J W Davis; D L Phreaner; D B Hoyt; R C Mackersie
Journal:  J Trauma       Date:  1993-03

6.  Role of routine emergency cervical radiography in head trauma.

Authors:  G B Gbaanador; A H Fruin; C Taylon
Journal:  Am J Surg       Date:  1986-12       Impact factor: 2.565

7.  Protocol-driven radiologic evaluation of suspected cervical spine injury: efficacy study.

Authors:  S E Mirvis; J N Diaconis; P A Chirico; B I Reiner; J N Joslyn; P Militello
Journal:  Radiology       Date:  1989-03       Impact factor: 11.105

8.  Canadian C-Spine Rule study for alert and stable trauma patients: I. Background and rationale.

Authors: 
Journal:  CJEM       Date:  2002-03       Impact factor: 2.410

9.  The Canadian C-spine rule versus the NEXUS low-risk criteria in patients with trauma.

Authors:  Ian G Stiell; Catherine M Clement; R Douglas McKnight; Robert Brison; Michael J Schull; Brian H Rowe; James R Worthington; Mary A Eisenhauer; Daniel Cass; Gary Greenberg; Iain MacPhail; Jonathan Dreyer; Jacques S Lee; Glen Bandiera; Mark Reardon; Brian Holroyd; Howard Lesiuk; George A Wells
Journal:  N Engl J Med       Date:  2003-12-25       Impact factor: 91.245

10.  Selective application of cervical spine radiography in alert victims of blunt trauma: a prospective study.

Authors:  R J Roberge; R C Wears; M Kelly; T C Evans; M A Kenny; R D Daffner; R Kremen; K Murray; E C Cottington
Journal:  J Trauma       Date:  1988-06
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  1 in total

Review 1.  Accuracy of the Canadian C-spine rule and NEXUS to screen for clinically important cervical spine injury in patients following blunt trauma: a systematic review.

Authors:  Zoe A Michaleff; Chris G Maher; Arianne P Verhagen; Trudy Rebbeck; Chung-Wei Christine Lin
Journal:  CMAJ       Date:  2012-10-09       Impact factor: 8.262

  1 in total

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