Comparison of the accuracy of plain radiography and CT scan in diagnosing cervical spineinjuries in trauma patients referred to the emergency department of Imam Hussein (AS)Hospital, Shahroud

Introduction: Trauma is the leading cause of death in developing countries. Head and neck trauma is one of the most common causes of referral to the emergency department following injuries resulting from motor vehicle accidents, sports, fights, and falls from heights. Cervical spine injuries account for ۲-۳% of trauma patients. This study was conducted to compare the accuracy of plain radiography and CT scan in diagnosing cervical spine injuries in trauma patients in Shahroud city.Materials and Methods: This descriptive-analytical study was conducted using a cross-sectional method and convenient sampling on ۱۱۵ cervical spine trauma victims referred to the emergency department of Imam Hossein (AS) Hospital in Shahroud in ۲۰۱۸-۲۰۱۹. Data were collected using a demographic information checklist. After collection, the data were entered into SPSS version ۲۳, WinPepi version ۱۱.۶۵, and MEDCALC statistical software and analyzed using descriptive-analytical statistics.Results: In this study, the results showed that out of ۱۱۵ patients with cervical spine injury, ۵۹.۱% were male and ۴۰.۹% were female. The mean age of the patients was ۳۹.۸ ± ۱۵.۳ years. Car accident, rollover and motorcycle accident were the most frequent mechanisms of injury to the patients with ۳۹.۱, ۲۴.۳ and ۲۰.۹% respectively. The sensitivity, specificity, positive and negative predictive value, positive and negative likelihood ratio and area under the Ruck curve for simple radiographs read by an emergency medicine specialist were ۵۵.۵۶, ۹۷.۱۷, ۲۶.۵, ۹۶.۶۲, ۱۹.۶۳, ۰.۴۶ and ۷۶% respectively. Also, the sensitivity, specificity, positive and negative predictive value, positive and negative likelihood ratio, and area under the Rock curve for plain radiographs read by a radiologist were ۰, ۰.۳۳, ۶۶.۶۷, ۱۰۰, ۱۰۰, ۹۷.۲۵, and ۸۳ percent, respectively.Conclusion: According to the results of the study, it can be stated that plain radiography cannot be considered an appropriate tool to rule out cervical vertebrae injuries caused by trauma. Also, taking radiography may be a waste of time for faster and better diagnosis, as well as a waste of money without achieving appropriate results, given the higher accuracy of CT scanning. Therefore, it is recommended to use CT scanning in case of clinical suspicion or if the radiography images do not meet the standards.Introduction: Trauma is the leading cause of death in developing countries. Head and neck trauma is one of the most common causes of referral to the emergency department following injuries resulting from motor vehicle accidents, sports, fights, and falls from heights. Cervical spine injuries account for ۲-۳% of trauma patients. This study was conducted to compare the accuracy of plain radiography and CT scan in diagnosing cervical spine injuries in trauma patients in Shahroud city. Materials and Methods: This descriptive-analytical study was conducted using a cross-sectional method and convenient sampling on ۱۱۵ cervical spine trauma victims referred to the emergency department of Imam Hossein (AS) Hospital in Shahroud in ۲۰۱۸-۲۰۱۹. Data were collected using a demographic information checklist. After collection, the data were entered into SPSS version ۲۳, WinPepi version ۱۱.۶۵, and MEDCALC statistical software and analyzed using descriptive-analytical statistics. Results: In this study, the results showed that out of ۱۱۵ patients with cervical spine injury, ۵۹.۱% were male and ۴۰.۹% were female. The mean age of the patients was ۳۹.۸ ± ۱۵.۳ years. Car accident, rollover and motorcycle accident were the most frequent mechanisms of injury to the patients with ۳۹.۱, ۲۴.۳ and ۲۰.۹% respectively. The sensitivity, specificity, positive and negative predictive value, positive and negative likelihood ratio and area under the Ruck curve for simple radiographs read by an emergency medicine specialist were ۵۵.۵۶, ۹۷.۱۷, ۲۶.۵, ۹۶.۶۲, ۱۹.۶۳, ۰.۴۶ and ۷۶% respectively. Also, the sensitivity, specificity, positive and negative predictive value, positive and negative likelihood ratio, and area under the Rock curve for plain radiographs read by a radiologist were ۰, ۰.۳۳, ۶۶.۶۷, ۱۰۰, ۱۰۰, ۹۷.۲۵, and ۸۳ percent, respectively. Conclusion: According to the results of the study, it can be stated that plain radiography cannot be considered an appropriate tool to rule out cervical vertebrae injuries caused by trauma. Also, taking radiography may be a waste of time for faster and better diagnosis, as well as a waste of money without achieving appropriate results, given the higher accuracy of CT scanning. Therefore, it is recommended to use CT scanning in case of clinical suspicion or if the radiography images do not meet the standards.

کلیدواژه ها:

Cervical Vertebrae ، Plain radiography ، CT scan ، Trauma