Department of Emergency Medicine, University of Health Sciences, Kartal Dr. Lütfi Kırdar City Hospital, İstanbul-Türkiye.
Ulus Travma Acil Cerrahi Derg. 2024 Apr;30(4):271-275. doi: 10.14744/tjtes.2024.39240.
Ankle injuries are a common reason for visits to the emergency department (ED). An effective diagnosis and treatment process is crucial for the swift recovery of patients and for alleviating congestion in EDs. This study aims to evaluate the adequacy and effectiveness of the Ottawa Ankle Rules (OAR) in geriatric patients presenting to the emergency department (ED).
Between February 2022 and November 2022, 160 patients aged 65 and older (118 women, 42 men) who presented to the ED with isolated ankle injuries were included in the study. We calculated the sensitivity, specificity, positive predictive value, and negative predictive value of the OAR.
The study found fractures in 37.5% of patients. The sensitivity of the OAR was 98.33%, the specificity was 86%, the negative predictive value was 98.85%, and the positive predictive value was 80.82%.
This study demonstrates that the OAR is highly sensitive in the geriatric population but shows some limitations in terms of specificity and positive predictive value. These results support the effectiveness of using the OAR in evaluating ankle injuries in the geriatric population but also highlight the need for cautious application due to the potential for false-positive outcomes.
踝关节损伤是急诊科(ED)就诊的常见原因。有效的诊断和治疗过程对于患者的快速康复和缓解 ED 的拥堵至关重要。本研究旨在评估渥太华踝关节规则(OAR)在急诊科就诊的老年患者中的充分性和有效性。
在 2022 年 2 月至 2022 年 11 月期间,共纳入 160 名年龄在 65 岁及以上(118 名女性,42 名男性)的因孤立性踝关节损伤就诊于 ED 的患者。我们计算了 OAR 的灵敏度、特异性、阳性预测值和阴性预测值。
研究发现 37.5%的患者存在骨折。OAR 的灵敏度为 98.33%,特异性为 86%,阴性预测值为 98.85%,阳性预测值为 80.82%。
本研究表明,OAR 在老年人群中具有高度的敏感性,但在特异性和阳性预测值方面存在一些局限性。这些结果支持在评估老年人群的踝关节损伤时使用 OAR 的有效性,但也强调由于可能出现假阳性结果,需要谨慎应用。