Blunt cerebrovascular injury: The case for universal screening.

The Journal of Trauma and Acute Care Surgery
Stefan W LeichtleMichel B Aboutanos

Abstract

Current evidence-based screening algorithms for blunt cerebrovascular injury (BCVI) may miss more than 30% of carotid or vertebral artery injuries. We implemented universal screening for BCVI with computed tomography angiography of the neck at our level 1 trauma center, hypothesizing that only universal screening would identify all clinically relevant BCVIs. Adult blunt trauma activations from July 2017 to August 2019 underwent full-body computed tomography scan including computed tomography angiography neck with a 128-slice computed tomography scanner. We calculated sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of common screening criteria. We determined independent risk factors for BCVI using multivariate analyses. A total of 4,659 patients fulfilled the inclusion criteria, 2.7% (n = 126) of which had 158 BCVIs. For the criteria outlined in the American College of Surgeons Trauma Quality Improvement Program Best Practices Guidelines, sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 72.2%, 64.9%, 6.8%, 98.5%, and 65.2%, respectively; for the risk factors suggested in the more extensive expanded Denver criteria, they were 82.5%, 50.4...Continue Reading

References

Aug 1, 1990·The Journal of Trauma·T C FabianK A Kudsk
May 1, 1996·Annals of Surgery·T C FabianF E Pritchard
Nov 24, 1999·The Journal of Trauma·W L BifflJ M Burch
Feb 12, 2000·American Journal of Surgery·W L BifflJ M Burch
Jun 24, 2000·The Journal of Trauma·E M BulgerG J Jurkovich
Mar 27, 2009·Lancet·Stefan Huber-WagnerUNKNOWN Working Group on Polytrauma of the German Trauma Society
Dec 8, 2010·Thrombosis and Haemostasis·Patrick HenryLudovic Drouet
May 26, 2011·The Journal of Trauma·Deborah KayeJohn A Weigelt
Jan 17, 2012·Journal of the American College of Surgeons·Randall W FranzJodi F Hartman
Feb 14, 2012·The Journal of Trauma and Acute Care Surgery·Clay Cothren BurlewDenis D Bensard
Mar 21, 2013·Insights Into Imaging·Matteo BonattiGiampietro Bonatti
Mar 23, 2013·Journal of the American College of Surgeons·Timothy C Fabian
Jan 25, 2014·The Journal of Trauma and Acute Care Surgery·Elena M PaulusMartin A Croce
Feb 21, 2014·The Journal of Trauma and Acute Care Surgery·Brandon Robert BrunsDeborah M Stein
Aug 19, 2016·The Journal of Trauma and Acute Care Surgery·Adriana LaserDeborah M Stein
Oct 19, 2016·American Journal of Surgery·Andrea E GeddesErnest E Moore
Apr 4, 2017·The American Journal of Emergency Medicine·Brit LongAlex Koyfman
May 31, 2018·The Journal of Trauma and Acute Care Surgery·Clay Cothren BurlewMitchell J Cohen
Oct 31, 2018·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Tor BrommelandElisabeth Jeppesen
Aug 28, 2019·The Journal of Trauma and Acute Care Surgery·Joshua J SumislawskiClay Cothren Burlew

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Citations

Jan 28, 2021·The Journal of Trauma and Acute Care Surgery·Jonathan A BlackJan O Jansen
Apr 21, 2021·The American Surgeon·Mary A McCulloughSamuel P Carmichael
Jun 26, 2021·The American Surgeon·Allyson M Hynes
Sep 21, 2021·The Journal of Trauma and Acute Care Surgery·Kelly VogtUNKNOWN Evidence Based Reviews in Surgery (EBRS) Group

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