Abdolrahimzadeh Fard Hossein, Mahmudi-Azer Salahaddin, Sefidbakht Sepideh, Iranpour Pooya, Bolandparvaz Shahram, Abbasi Hamid Reza, Paydar Shahram, Sabetian Golnar, Mahmoudi Mohamad Mahdi, Zare Masoume, Shayan Leila, Salimi Maryam
Trauma Research Center, Department of Surgery, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
Pulmonary Research Group, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
Emerg Med Int. 2021 Jun 28;2021:4188178. doi: 10.1155/2021/4188178. eCollection 2021.
BACKGROUND: The lack of enough medical evidence about COVID-19 regarding optimal prevention, diagnosis, and treatment contributes negatively to the rapid increase in the number of cases globally. A chest computerized tomography (CT) scan has been introduced as the most sensitive diagnostic method. Therefore, this research aimed to examine and evaluate the chest CT scan as a screening measure of COVID-19 in trauma patients. METHODS: This cross-sectional study was conducted in Rajaee Hospital in Shiraz from February to May 2020. All patients underwent unenhanced CT with a 16-slice CT scanner. The CT scans were evaluated in a blinded manner, and the main CT scan features were described and classified into four groups according to RSNA recommendation. Subsequently, the first two Radiological Society of North America (RSNA) categories with the highest probability of COVID-19 pneumonia (i.e., typical and indeterminate) were merged into the "positive CT scan group" and those with radiologic features with the least probability of COVID-19 pneumonia into "negative CT scan group." RESULTS: Chest CT scan had a sensitivity of 68%, specificity of 56%, positive predictive value of 34.8%, negative predictive value of 83.7%, and accuracy of 59.3% in detecting COVID-19 among trauma patients. Moreover, for the diagnosis of COVID-19 by CT scan in asymptomatic individuals, a sensitivity of 100%, specificity of 66.7%, and negative predictive value of 100% were obtained ( value: 0.05). CONCLUSION: Findings of the study indicated that the CT scan's sensitivity and specificity is less effective in diagnosing trauma patients with COVID-19 compared with nontraumatic people.
背景:关于新型冠状病毒肺炎(COVID-19)的最佳预防、诊断和治疗,缺乏足够的医学证据,这对全球病例数的迅速增加产生了负面影响。胸部计算机断层扫描(CT)已被引入作为最敏感的诊断方法。因此,本研究旨在检查和评估胸部CT扫描作为创伤患者中COVID-19的筛查措施。 方法:本横断面研究于2020年2月至5月在设拉子的拉贾伊医院进行。所有患者均使用16层CT扫描仪进行平扫。CT扫描以盲法进行评估,主要的CT扫描特征根据北美放射学会(RSNA)的建议进行描述并分为四组。随后,将北美放射学会(RSNA)中COVID-19肺炎可能性最高的前两类(即典型和不确定)合并为“CT扫描阳性组”,而将COVID-19肺炎可能性最小的放射学特征的患者合并为“CT扫描阴性组”。 结果:胸部CT扫描在检测创伤患者中的COVID-19时,敏感性为68%,特异性为56%,阳性预测值为34.8%,阴性预测值为83.7%,准确性为59.3%。此外,对于无症状个体通过CT扫描诊断COVID-19,获得的敏感性为100%,特异性为66.7%,阴性预测值为100%(P值:0.05)。 结论:研究结果表明,与非创伤患者相比,CT扫描在诊断COVID-19创伤患者时的敏感性和特异性较低。
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