Usage of Ottawa Ankle Rules to Minimize the Amount of Radiological Examination in Case of Ankle Injuries in Emergency Room Settings
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Date
2020
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Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Otavas potītes vadlīnijas 1992. gadā izveidoja Stiell et al. ar mērķi samazināt nevajadzīgu radioloģisko izmeklējumu apjomu. Dažos reģionos izpratne par Otavas potīšu vadlīnijām joprojām ir nepilnīga un to ieviešana praksē nav pabeigta. Tāpēc joprojām ir iespējams samazināt nevajadzīgu radioloģisko izmeklējumu skaitu. Tika izvērtētas vairākas pieejas, lai samazinātu radioloģisko izmeklējumu skaitu potītes traumas gadījumā.
Literatūras pārskats tika veikts, lai pētītu pašreizējos pētījumus un statistikas datus, un meklētu alternatīvus risinājumus radioloģisko izmeklējumu skaita samazināšanai uzņemšanas nodaļā.
Izmantojot Otavas noteikumus ir iespējams samazināt radioloģisko izmeklējumu skaitu pēdas vai potītes traumu gadījumā par aptuveni 30%. Buffalo vadlīnijas ļauj palielināt relatīvi zemo Otavas potīšu vadlīniju specifiskumu un samazināt izmeklējumu skaitu vēl par papildus 25%. Otavas noteiktumu pielietošana ir informatīva arī negatīvas atrades gadījumā. Salīdzinoši nesen izstrādāti arī jaunākas Bernese vadlīnijas, kurām ir augstāks specifiskums, taču tām ir vajadzīgi turpmāki pētījumi. Pielietojot ultrasonogrāfijas izmeklējumus pacientiem ar pozitīvu Otavas vadlīniju atradi iespējams samazināt citu radioloģisko izmeklējumu skaitu par aptuveni 80%, taču tas ir laikietilpīgi un prasa papildus resursus. Šie faktori mazina šīs metodes potenciālos ieguvumus.
Veikts literatūras apskats. Izmantotie atslēgas vārdi: Ottawa ankle rules, Ankle fracture diagnostics and Ottawa ankle rule implementation.
The Ottawa ankle rules were established in 1992 by Stiell et al. with the aim to reduce the amount of unnecessary radiological examinations. The awareness of Ottawa ankle rules and implementation in clinical settings in some regions is still low, therefore, a further reduction of number of unnecessary radiographic examinations is still possible. Several approaches to reduce the number of radiographs after a foot or ankle trauma were evaluated. The literature review was carried out to determine current state of studies and statistical evidence regarding the Ottawa ankle rules and alternatives to reduce unnecessary radiological examinations in emergency departments. The Ottawa ankle rules can reduce radiographic examinations after a foot or ankle trauma by approximately 30%. The addition of the Buffalo rule, in case of malleolar pain, could reduce the amount of radiographic examinations for this injured region by another 25% beyond that using Ottawa ankle rules for malleolar testing. Buffalo test could be beneficial to increase the low specificity of Ottawa ankle rules. In case of a negative test result, the Ottawa ankle rule is highly informative. The newer Bernese ankle rule has a higher specificity but needs further studies. Additionally, the use of bedside ultrasound on patients with positive Ottawa ankle rule can reduce the number of radiographic examinations by approximately 80%. Depending on the hospital setting, bedside ultrasound requires more resources and is more time consuming, thus reducing potential benefits. A literature review was performed. Key words: Ottawa ankle rules, Ankle fracture diagnostics and Ottawa ankle rule implementation.
The Ottawa ankle rules were established in 1992 by Stiell et al. with the aim to reduce the amount of unnecessary radiological examinations. The awareness of Ottawa ankle rules and implementation in clinical settings in some regions is still low, therefore, a further reduction of number of unnecessary radiographic examinations is still possible. Several approaches to reduce the number of radiographs after a foot or ankle trauma were evaluated. The literature review was carried out to determine current state of studies and statistical evidence regarding the Ottawa ankle rules and alternatives to reduce unnecessary radiological examinations in emergency departments. The Ottawa ankle rules can reduce radiographic examinations after a foot or ankle trauma by approximately 30%. The addition of the Buffalo rule, in case of malleolar pain, could reduce the amount of radiographic examinations for this injured region by another 25% beyond that using Ottawa ankle rules for malleolar testing. Buffalo test could be beneficial to increase the low specificity of Ottawa ankle rules. In case of a negative test result, the Ottawa ankle rule is highly informative. The newer Bernese ankle rule has a higher specificity but needs further studies. Additionally, the use of bedside ultrasound on patients with positive Ottawa ankle rule can reduce the number of radiographic examinations by approximately 80%. Depending on the hospital setting, bedside ultrasound requires more resources and is more time consuming, thus reducing potential benefits. A literature review was performed. Key words: Ottawa ankle rules, Ankle fracture diagnostics and Ottawa ankle rule implementation.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Ottawa ankle rules, Ankle fracture diagnostics and Ottawa ankle rule implementation, Ottawa ankle rules, Ankle fracture diagnostics and Ottawa ankle rule implementation