加拿大制定的轻度颅脑损伤头颅CT规则优于新奥尔良的
Canadian CT head Rule Is Superior to New Orleans Criteria in Minor Head injury
In patients with Glasgow Coma Scale scores of 15, both decision rules had 100% sensitivity for identifying significant intracranial injuries, but the Canadian CT Head Rule had higher specificity.
In a prospective cohort study, the authors compared sensitivity and specificity of the Canadian CT Head Rule and the New Orleans Criteria (JW Emerg Med Dec 21 2005) for identifying intracranial injuries in adults with minor head injury (defined as those with witnessed loss of consciousness, disorientation, or amnesia, and Glasgow Coma Scale [GCS] score 13 to 15). Of 431 consecutive patients enrolled at a single level I trauma center in the U.S., 314 who had GCS scores of 15 and underwent head computed tomography (CT) scanning were the focus of the study.
Of the 314 patients, 22 suffered any traumatic intracranial injuries, 11 had clinically important brain lesions (defined as acute traumatic lesions that would normally require hospital admission and neurological follow-up), and 3 had injuries requiring neurosurgical intervention. Both rules were 100% sensitive for identifying patients with each of these three outcomes, but the Canadian CT Head Rule had significantly higher specificity than the New Orleans Criteria (36% vs. 10%, 35% vs. 10%, and 81% vs. 10%, respectively).
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