Expanded screening criteria for blunt cerebrovascular injury: a bigger impact than anticipated
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- 作者：Andrea E. Geddes ; M.S. ; Clay Cothren Burlew ; M.D. ; clay.cothren@dhha.org ; Amy E. Wagenaar ; B.A. ; Walter L. Biffl ; M.D. ; Jeffrey L. Johnson ; M.D. ; Fredric M. Pieracci ; M.D. ; Eric M. Campion ; M.D. ; Ernest E. Moore ; M.D.
- 关键词：Blunt cerebrovascular injuries ; Carotid artery injury ; Vertebral artery injury ; Screening criteria ; Traumatic vascular injury ; Stroke
- 刊名：The American Journal of Surgery
- 出版年：2016
- 出版时间：December 2016
- 年：2016
- 卷：212
- 期：6
- 页码：1167-1174
- 全文大小：293 K
- 卷排序：212
文摘
We implemented expanded screening criteria for blunt cerebrovascular injuries (BCVIs) in an attempt to capture the remaining 20% of patients not historically identified with earlier protocols. We hypothesized that these expanded criteria would capture the additional 20% of BCVI patients not previously identified.MethodsScreening criteria for BCVI were expanded in 2011 after identifying new injury patterns. The study population included 4 years prior (2007 to 2010; classic) and following (2011 to 2014; expanded) implementation of expanded criteria.ResultsBCVIs were identified in 386 patients: 150 during the classic period (2.36% incidence) and 236 in the expanded period (2.99% incidence). In the expanded period, 155 patients were imaged based on classic screening criteria, 62 on expanded criteria (21 complex skull fractures, 20 upper rib fractures, 6 mandible fractures, 2 scalp degloving, 1 great vessel injury, and 12 combination), and 19 for other injuries and symptoms.ConclusionsThere was a significant increase in the identification of BCVI following the adoption of expanded screening criteria, resulting in a substantial reduction of missed injuries. Expanded criteria should be adopted when screening for BCVI.