Anterior-posterior view by full-body digital X-ray to rule out severe spina injuries in Polytraumatized patients
Dublin Core
Title
Anterior-posterior view by full-body digital X-ray to rule out severe spina injuries in Polytraumatized patients
Subject
Spinal injuries, LODOX-Statscan, Diagnostic accuracy, Full-body digital X-ray, Radiography
Description
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 timesaving 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 [greater than or
equai to] 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 [+ or -]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.
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 timesaving 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 [greater than or
equai to] 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 [+ or -]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.
Creator
Sonja Häckel, Elena Hofmann, Helen Anwander, Christoph E. Albers, Jasmin Basedow and Sebastian F. Bigdon
Date
Mar. 5, 2021
Contributor
Fajar bagus W
Format
PDF
Language
Indonesia
Type
Text
Files
Collection
Citation
Sonja Häckel, Elena Hofmann, Helen Anwander, Christoph E. Albers, Jasmin Basedow and Sebastian F. Bigdon, “Anterior-posterior view by full-body digital X-ray to rule out severe spina injuries in Polytraumatized patients,” Repository Horizon University Indonesia, accessed April 14, 2025, https://repository.horizon.ac.id/items/show/3769.