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

Simple item page
dc.contributor.authorHäckel, Sonja
dc.contributor.authorHofmann, Elena
dc.contributor.authorAnwander, Helen
dc.contributor.authorAlbers, Christoph E
dc.contributor.authorBasedow, Jasmin
dc.contributor.authorBigdon, Sebastian F.
dc.contributor.authorExadaktylos, Aristomenis K
dc.contributor.authorKeel, Marius J B
dc.contributor.authorDunn, Robert N
dc.contributor.authorMaqungo, Sithombo
dc.contributor.authorBenneker, Lorin M
dc.contributor.authorHeld, Michael
dc.contributor.authorHoppe, Sven
dc.date.accessioned2021-10-12T05:28:48Z
dc.date.available2021-10-12T05:28:48Z
dc.date.issued2021-03-05
dc.date.updated2021-03-07T04:22:15Z
dc.description.abstractBackground 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.en_US
dc.identifier.apacitationHäckel, S., Hofmann, E., Anwander, H., Albers, C. E., Basedow, J., Bigdon, Sebastian F., ... Hoppe, S. (2021). Anterior-posterior view by full-body digital X-ray to rule out severe spinal injuries in Polytraumatized patients. <i>BMC Emergency Medicine</i>, 21(Article number: 27), http://hdl.handle.net/11427/35176en_ZA
dc.identifier.chicagocitationHäckel, Sonja, Elena Hofmann, Helen Anwander, Christoph E Albers, Jasmin Basedow, Sebastian F. Bigdon, Aristomenis K Exadaktylos, et al "Anterior-posterior view by full-body digital X-ray to rule out severe spinal injuries in Polytraumatized patients." <i>BMC Emergency Medicine</i> 21, Article number: 27. (2021) http://hdl.handle.net/11427/35176en_ZA
dc.identifier.citationHäckel, S., Hofmann, E., Anwander, H., Albers, C.E., Basedow, J., Bigdon, Sebastian F., Exadaktylos, A.K. & Keel, M.J.B. et al. 2021. Anterior-posterior view by full-body digital X-ray to rule out severe spinal injuries in Polytraumatized patients. <i>BMC Emergency Medicine.</i> 21(Article number: 27) http://hdl.handle.net/11427/35176en_ZA
dc.identifier.ris TY - Journal Article AU - Häckel, Sonja AU - Hofmann, Elena AU - Anwander, Helen AU - Albers, Christoph E AU - Basedow, Jasmin AU - Bigdon, Sebastian F. AU - Exadaktylos, Aristomenis K AU - Keel, Marius J B AU - Dunn, Robert N AU - Maqungo, Sithombo AU - Benneker, Lorin M AU - Held, Michael AU - Hoppe, Sven AB - 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. DA - 2021-03-05 DB - OpenUCT DP - University of Cape Town IS - Article number: 27 J1 - BMC Emergency Medicine KW - Spinal injuries KW - LODOX-Statscan KW - Diagnostic accuracy KW - Full-body digital X-ray KW - Radiography LK - https://open.uct.ac.za PY - 2021 T1 - Anterior-posterior view by full-body digital X-ray to rule out severe spinal injuries in Polytraumatized patients TI - Anterior-posterior view by full-body digital X-ray to rule out severe spinal injuries in Polytraumatized patients UR - http://hdl.handle.net/11427/35176 ER - en_ZA
dc.identifier.urihttps://doi.org/10.1186/s12873-021-00419-1
dc.identifier.urihttp://hdl.handle.net/11427/35176
dc.identifier.vancouvercitationHäckel S, Hofmann E, Anwander H, Albers CE, Basedow J, Bigdon Sebastian F, et al. Anterior-posterior view by full-body digital X-ray to rule out severe spinal injuries in Polytraumatized patients. BMC Emergency Medicine. 2021;21(Article number: 27) http://hdl.handle.net/11427/35176.en_ZA
dc.language.isoenen_US
dc.language.rfc3066en
dc.publisher.departmentDivision of Orthopaedic Surgeryen_US
dc.publisher.facultyFaculty of Health Sciencesen_US
dc.rights.holderThe Author(s)
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en_US
dc.sourceBMC Emergency Medicineen_US
dc.source.journalissueArticle number: 27en_US
dc.source.journalvolume21en_US
dc.source.urihttps://bmcemergmed.biomedcentral.com/
dc.subjectSpinal injuriesen_US
dc.subjectLODOX-Statscanen_US
dc.subjectDiagnostic accuracyen_US
dc.subjectFull-body digital X-rayen_US
dc.subjectRadiographyen_US
dc.titleAnterior-posterior view by full-body digital X-ray to rule out severe spinal injuries in Polytraumatized patientsen_US
dc.typeJournal Articleen_US
Files
Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
12873_2021_Article_419.pdf
Size:
988.33 KB
Format:
Adobe Portable Document Format
Description:
Download
License bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
license.txt
Size:
0 B
Format:
Item-specific license agreed upon to submission
Description:
Download
Collections
Journal Articles