Near Infrared Spectroscopy as a Diagnostic Tool for Screening of Intracranial Hematomas; A Systematic Review and Meta-Analysis.

Introduction: Evidence supports the clinical applicability of near-infrared spectroscopy (NIRS) in intracranial hematoma detection in prehospital settings. This systematic review and meta-analysis aimed to determine the diagnostic yield of NIRS for detecting intracranial hematoma in traumatic brain...

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Publicado en:Archives of Academic Emergency Medicine Vol. 13; no. 1; pp. 1 - 14
Autores principales: Zarei, Hamed, Zarrin, Amirali, Janmohamadi, Mahrokh, Saadatipour, Narges, Yarahmadi, Mobina, Moeini, Mohammadmobin, Ardekani, Shireen Shams, Safdarian, Ali, Vazirizadeh-Mahabadi, Mohammadhossein, Babaei, Mohammadhossein, Bagheri, Negin, Gholipour, Amirhossein, Azadi, Mohammadreza, Parvari, Soraya, Azimi, Amir
Formato: meta analysis research systematic review tables/charts Journal Article
Publicado: Shahid Beheshti University of Medical Sciences 2025
Acceso en línea:Ver este registro en EBSCOhost
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        atl: Near Infrared Spectroscopy as a Diagnostic Tool for Screening of Intracranial Hematomas; A Systematic Review and Meta-Analysis.
      aug:
        au:
          Zarei, Hamed
          Zarrin, Amirali
          Janmohamadi, Mahrokh
          Saadatipour, Narges
          Yarahmadi, Mobina
          Moeini, Mohammadmobin
          Ardekani, Shireen Shams
          Safdarian, Ali
          Vazirizadeh-Mahabadi, Mohammadhossein
          Babaei, Mohammadhossein
          Bagheri, Negin
          Gholipour, Amirhossein
          Azadi, Mohammadreza
          Parvari, Soraya
          Azimi, Amir
        affil: Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran.
      sug:
        subj:
          Spectroscopy, Near-Infrared Utilization
          Hematoma, Subdural Diagnosis
          Diagnostic Imaging Methods
          Human
          Systematic Review
          Meta Analysis
          PubMed
          Medline
          Embase
          Tomography, X-Ray Computed
          Magnetic Resonance Imaging
          Professional Practice, Evidence-Based
          Emergency Medical Services
          Emergency Service
          Point-of-Care Testing
          Brain Concussion Diagnosis
      ab: Introduction: Evidence supports the clinical applicability of near-infrared spectroscopy (NIRS) in intracranial hematoma detection in prehospital settings. This systematic review and meta-analysis aimed to determine the diagnostic yield of NIRS for detecting intracranial hematoma in traumatic brain injury (TBI) patients. Methods: A systematic search was performed in July 2024 in Medline, Embase, Scopus, and Web of Science databases. We included studies that evaluated the diagnostic performance of NIRS in detecting intracranial hematoma in both adult and pediatric patients suspected of TBI in prehospital or emergency settings, using brain computed tomography (CT) scan or magnetic resonance imaging as the gold standard. Results: Eighteen studies enrolling 2979 patients were included. NIRS exhibited an Area Under the Curve (AUC) of 0.91 (95% confidence interval [CI]: 0.88, 0.93), with a sensitivity of 0.86 (95% CI: 0.78, 0.91), and specificity of 0.82 (95% CI: 0.72, 0.89) across all age groups. In children, the results demonstrated an AUC of 0.92 (95% CI: 0.89, 0.94), sensitivity of 0.95 (95% CI: 0.21, 1.00), and specificity of 0.81 (95% CI: 0.65, 0.91). Among adults, the AUC was 0.91 (95% CI: 0.88, 0.93), with sensitivity and specificity of 0.86 (95% CI: 0.78, 0.92) and 0.83 (95% CI: 0.70, 0.91), respectively. Performance improved when NIRS was operated by non-physicians (AUC = 0.94 [95% CI: 0.91, 0.96], sensitivity = 0.90 [95% CI: 0.79, 0.95], specificity = 0.85 [95% CI: 0.71, 0.93]) compared to physicians (AUC = 0.90 [95% CI: 0.87, 0.92], sensitivity = 0.88 [95% CI: 0.77, 0.94], specificity = 0.75 [95% CI: 0.59, 0.76]). Patients’ age group and operator type were identified as potential sources of heterogeneity. Sensitivity analyses confirmed the robustness of the findings, particularly in mild TBI cases and studies implementing a OD > 0.2 as the threshold for a positive NIRS result. Conclusion: NIRS proves to be an effective diagnostic tool for detecting traumatic intracranial hematoma in both pediatric and adult groups, with high sensitivity and specificity. Its utility in prehospital triage, operated by physicians or paramedics, underscores its potential for broader clinical application.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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