Clinical validation of the "Straight-Leg-Evaluation-Trauma-Test" (SILENT) as a rapid assessment tool for injuries of the lower extremity in trauma bay patients.
Purpose: Clinical assessment of the major trauma patient follows international validated guidelines without standardized trauma-specific assessment of the lower extremities for injuries. This study aimed to validate a novel clinical test for lower extremity evaluation during trauma resuscitation pha...
| Publicado en: | European Journal of Trauma & Emergency Surgery Vol. 50; no. 3; pp. 1119 - 1126 |
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| Autores principales: | , , , , , , , |
| Formato: | algorithm research tables/charts Journal Article |
| Publicado: |
Springer Nature
Jun2024
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=178443678&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 178443678 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 18639933 3C05 jtl: European Journal of Trauma & Emergency Surgery issn: 18639933 maglogo: N pubinfo: dt: Jun2024 vid: 50 iid: 3 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 178443678 174967673 178443678 178443678 10.1007/s00068-023-02437-z 178443678 ppf: 1119 ppct: 7 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Clinical validation of the "Straight-Leg-Evaluation-Trauma-Test" (SILENT) as a rapid assessment tool for injuries of the lower extremity in trauma bay patients. aug: au: Berk, Till Neuhaus, Valentin Nierlich, Catalina Balogh, Zsolt J. Klingebiel, Felix Karl-Ludwig Kalbas, Yannik Pape, Hans-Christoph Halvachizadeh, Sascha affil: https://ror.org/01462r250 Department of Trauma, University Hospital Zurich, Raemistrasse 100, 8091, Zurich, Switzerland sug: subj: Instrument Validation Clinical Assessment Tools Lower Extremity Injuries Emergency Patients Trauma Centers Human Nonexperimental Studies Fractures, Open Tomography, X-Ray Computed Sensitivity and Specificity ROC Curve Middle Age Tibial Fractures Physical Examination Middle Aged: 45-64 years ab: Purpose: Clinical assessment of the major trauma patient follows international validated guidelines without standardized trauma-specific assessment of the lower extremities for injuries. This study aimed to validate a novel clinical test for lower extremity evaluation during trauma resuscitation phase. Methods: This diagnostic, prognostic observational cohort study was performed on trauma patient treated at one level I trauma center between Mar 2022 and Mar 2023. The Straight-Leg-Evaluation-Trauma (SILENT) test follows three steps during the primary survey: inspection for obvious fractures (e.g., open fracture), active elevation of the leg, and cautious elevation of the lower extremity from the heel. SILENT was considered positive when obvious fracture was present and painful or pathological mobility was observed. The SILENT test was compared with standardized radiographs (CT scan or X-ray) as the reference test for fractures. Statistical analysis included sensitivity, specificity, and receiver operating characteristic testing. Results: 403 trauma bay patients were included, mean age 51.6 (SD 21.2) years with 83 fractures of the lower extremity and 27 pelvic/acetabular fractures. Overall sensitivity was 75% (95%CI 64 to 84%), and overall specificity was 99% (95%CI 97 to 100%). Highest sensitivity was for detection of tibia fractures (93%, 95%CI 77 to 99%). Sensitivity of SILENT was higher in the unconscious patient (96%, 95%CI 78 to 100%) with a near 100% specificity. AUC was highest for tibia fractures (0.96, 95%CI 0.92 to 1.0) followed by femur fractures (0.92, 95%CI 0.84 to 0.99). Conclusion: The SILENT test is a clinical applicable and feasible rule-out test for relevant injuries of the lower extremity. A negative SILENT test of the femur or the tibia might reduce the requirement of additional radiological imaging. Further large-scale prospective studies might be required to corroborate the beneficial effects of the SILENT test. pubtype: Academic Journal doctype: algorithm research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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