PDF(Pubmed)
Abstract：
Several guidelines on the evaluation of patients with suspected cervical spine trauma in the Emergency Department (ED) exist. High heterogeneity between different guidelines has been reported. Aim of this study was to find areas of agreement and disagreement between guidelines, to identify topics in which further research is needed and to provide an evidence-based cervical spine trauma algorithm for ED physicians. The three most relevant guidelines published on cervical spine trauma in the last 10 years were selected screening websites of the main scientific societies and through the comparison of a normalized Google Scholar and SCOPUS citation index. We compared the selected guidelines through seven a-priori defined questions. In case of disagreement between the guidelines or if the quality of evidence appeared low, evidence from published systematic reviews on the topic was added to build an evidence-based algorithm for approach to spinal trauma in the ED. The three selected guidelines were: NICE 2016, Eastern Association for the Surgery of Trauma 2009 and American Association of Neurological Surgeons and Congress of Neurological Surgeons 2013. We found complete agreement on one question, partial agreement for one questions, no agreement for two questions, while agreement was not assessable for 3 questions. The agreement between different guidelines and the evidence on which recommendations are based is low. An attempt to build an evidence-based algorithm has been made. More studies are needed on many topics.
摘要：
在急诊科（ED）中存在一些关于评估可疑颈椎创伤患者的指南。据报道，不同指南之间存在高度异质性。这项研究的目的是找到准则之间的一致和分歧的领域，确定需要进一步研究的主题，并为ED医生提供基于证据的颈椎创伤算法。在过去的10年中，关于颈椎创伤的三个最相关的指南是选择主要科学学会的筛选网站，并通过比较标准化的GoogleScholar和SCOPUS引文索引。我们通过七个先验定义的问题比较了选定的指南。如果指南之间存在分歧，或者证据质量似乎很低，我们增加了有关该主题的已发表系统评价的证据,以建立一种基于证据的ED脊柱创伤方法算法.选择的三个指南是：NICE2016，东方创伤外科协会2009和美国神经外科医师协会和神经外科医师大会2013。我们在一个问题上达成了完全一致，部分同意一个问题，没有两个问题的协议，而协议是不可评估的3个问题。不同指南与建议所依据的证据之间的一致性很低。已经尝试构建基于证据的算法。需要对许多主题进行更多研究。
