Nomogram of Shibahashi et al to Screen for Blunt Cerebrovascular Injury

Description

Shibahashi et al reported a nomogram that help to predict the probability of blunt cerebrovascular injury. This can help to identify a patient who may require a more complete evaluation. The authors are from Tokyo Metropolitan Bokutoh Hospital and Chiba University in Japan.

Patient selection: blunt trauma

Parameters:

(1) sex

(2) high speed impact

(3) hypotension on arrival at trauma center

(4) Glasgow coma scale (GCS)

Parameter	Finding	Points
sex	female	0
	male	20.9
high speed impact	no	0
	yes	15
hypotension	no	0
	yes	48.2
Glasgow coma scale	3 to 8	80.2
	9 to 15	0
injury to face	no	0
	yes	33.3
injury to neck	no	0
	yes	63.8
injury to spine	no	0
	yes	96.6
injury to lower extremity	no	45.2
	yes	0
supratentorial subdural	no	41.8
	yes	0
skull base fracture	no	0
	yes	67.5
cervical spine fracture or subluxation	no	0
	yes	100
lumbar spine fracture or sublunxation	no	81.7
	yes	0
soft tissue injury to face	no	45.4
	yes	0

total score =

= SUM(points for all of the parameters)

Interpretation:

• minimum score: 0

• maximum score: 739.7

• The higher the score the greater the risk of cerebrovascular injury.

• The maximum risk reported is less than 50%.

value of X =

= (0.01245 * (score)) - 9.398

probability of cerebrovascular injury =

= 1 / (1 + EXP((-1) * X))

Performance:

• The area under the ROC curve according to the authors is 0.83 (higher if definition narrowed to carotid and vertebral arteries).

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Nomogram of Shibahashi et al to Screen for Blunt Cerebrovascular Injury

Description

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