Affiliation:
1. Russell H. Morgan Department of Radiology and Radiological Science Johns Hopkins Medical Institution Baltimore Maryland USA
2. Department of Radiology Tehran University of Medical Sciences Tehran Iran
3. Department of Emergency Medicine Johns Hopkins Medical Institution Baltimore Maryland USA
Abstract
AbstractBackgroundCervical spine computed tomography (CSCT) scans are frequently performed in older emergency department (ED) trauma patients based on the 65‐year‐old high‐risk criterion of the Canadian Cervical Spine Rule (CCR). We sought to determine the positivity rate of CSCT scans in symptomatic and asymptomatic patients to assess the current applicability of age in the CCR.MethodsWe reviewed CSCT ED reports from two institutional hospitals from 2018 to 2023. The primary variable was age; however, we also recorded fracture types and sites and type of treatments. Patients were separated into symptomatic and asymptomatic cohorts. We used a Fisher's exact test to compare variables between the asymptomatic and symptomatic groups and chi‐square tests for comparison between age groups.ResultsOf 9455 CSCTs performed in patients ≥ 65 years, 192 (2.0%) fractures were identified (113 females); 28 (0.30%) were in asymptomatic patients. The rates of fractures (1.6%) and asymptomatic fractures (0.18%) were lowest in the 65‐ to 70‐year age group. There were no distinguishing features as to the level or part of the vertebra fractured or surgical treatment rate between asymptomatic and symptomatic patients.ConclusionsCervical spine fractures in posttrauma patients ≥ 65 years are uncommon, with the lowest incidence in those 65 to 70 years old. Excluding asymptomatic individuals aged 65–70 from routine CSCT presents a minimal risk of missed fractures (0.18%). This prompts consideration for refining age‐based screening and integrating shared decision making into the clinical protocol for this demographic, reflecting the low incidence of fractures and the changing health profile of the aging population.
Reference16 articles.
1. Health United States 2020–2021.Table “Initial injury‐related visits to hospital emergency departments by sex age and intent and mechanism of injury: United States average annual selected years 2005–2006 through 2017–2018.” National Center for Health Statistics. Accessed 26 June 2023.https://www.cdc.gov/nchs/hus/data‐finder.htm
2. WeissAJ ReidLD BarrettML.Overview of emergency department visits related to injuries by cause of injury.2017. Accessed 20 Nov 2020.https://hcup‐us.ahrq.gov/reports/statbriefs/sb266‐Injuries‐Causes‐ED‐Visits‐2017.jsp
3. LaurenM ArmstrongDM VespaJ.Demographic Turning Points for the United States: Population Projections for 2020 to 2060. Report Number P25‐1144. United States Census Bureau. Accessed 3 July 2024.2020.https://www.census.gov/library/publications/2020/demo/p25‐1144.html
4. Canadian C-spine rule and the National Emergency X-Radiography Utilization Study (NEXUS) for detecting clinically important cervical spine injury following blunt trauma
5. The Canadian C-Spine Rule for Radiography in Alert and Stable Trauma Patients
Cited by
2 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献