Paxton Mark, Heal Clare F, Drobetz Herwig
James Cook University, School of Medicine and Dentistry, Mackay Base Hospital, Mackay, Australia.
J Med Imaging Radiat Oncol. 2012 Oct;56(5):514-8. doi: 10.1111/j.1754-9485.2012.02430.x. Epub 2012 Sep 5.
Cervical spine radiography may be over-utilised in an emergency department setting. The Canadian C-Spine Rule has been developed to reduce unnecessary radiography. Our aim was to retrospectively determine the proportion of cervical spine radiographs requested through the emergency department for trauma patients that were clinically indicated, according to the Canadian C-Spine Rule.
This was a cross-sectional survey conducted at a regional centre in Northern Queensland, Australia. All cervical spine radiographs for trauma, performed at the Mackay Base Hospital from 1 January 2009 to the 31 December 2009, were reviewed. The relevant patient charts were audited for evidence of indications for radiography.
Of 406 patients in the study, 155 patients (38%) (95% confidence interval 33.3%, 42.7%) had cervical spine imaging performed that was not indicated according to the Canadian C-Spine Rule. None of these patients had a significant cervical spine injury on radiography.
Applying the Canadian C-Spine Rule would have safely reduced the incidence of cervical spine radiography by 38%. This would also reduce costs, patient morbidity and radiation exposure.
在急诊科环境中，颈椎X光检查可能存在过度使用的情况。加拿大颈椎规则已被制定出来以减少不必要的X光检查。我们的目的是根据加拿大颈椎规则，回顾性地确定通过急诊科为创伤患者开具的颈椎X光片在临床上有指征的比例。
这是在澳大利亚昆士兰北部一个区域中心进行的横断面调查。对2009年1月1日至2009年12月31日在麦凯基地医院进行的所有创伤患者的颈椎X光片进行了审查。对相关患者病历进行审核，以寻找X光检查指征的证据。
在该研究的406名患者中，有155名患者（38%）（95%置信区间为33.3%，42.7%）进行了不符合加拿大颈椎规则指征的颈椎成像检查。这些患者在X光检查中均未发现明显的颈椎损伤。
应用加拿大颈椎规则可安全地将颈椎X光检查的发生率降低38%。这也将降低成本、患者发病率和辐射暴露。
