CLINICAL DECISION RULES DISCRIMINATE BETWEEN FRACTURES AND NONFRACTURES IN ACUTE ISOLATED KNEE TRAUMA

被引：23

作者：

WEBER, JE ^{[1
]}

JACKSON, RE ^{[1
]}

PEACOCK, WF ^{[1
]}

SWOR, RA ^{[1
]}

CARLEY, R ^{[1
]}

LARKIN, GL ^{[1
]}

机构：

[1] WILLIAM BEAUMONT HOSP,DEPT EMERGENCY MED,ROYAL OAK,MI 48073

来源：

ANNALS OF EMERGENCY MEDICINE | 1995年 / 26卷 / 04期

关键词：

D O I：

10.1016/S0196-0644(95)70109-5

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Design: A prospective survey of emergency department patients over a 7-month period. Standardized data forms were completed by emergency physicians, residents, and certified physician assistants. Setting: A large suburban community teaching hospital. Participants: Two hundred forty-two patients older than 17 years with isolated knee injuries sustained less than 24 hours previously. Results: We constructed a clinical decision model, calculating sensitivity, specificity, and odds ratios. Twenty-eight patients (11.6%) had fractures, with the patella the most commonly fractured osseous structure. Patients able to walk without limping had not experienced a fracture, nor had patients with twist injuries without effusion. Sensitivity of this model for detecting fracture was 1.0 (99% confidence interval, .97 to 1.0), and specificity was .337 (99% confidence interval, .26 to .42). Conclusion: Clinical decision rules are effective in detecting knee fractures with 100% sensitivity and with sufficient specificity to eliminate 29% of knee radiographs in the ED. These findings require prospective validation.

引用

页码：429 / 433

页数：5

共 12 条

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