Diagnostic accuracy of a near-infrared spectroscopy device for detecting intracranial hemorrhage in mild closed traumatic brain injury at a Philippine Trauma Center.

Brent Andrew G Viray; Halima O Mokamad-romancap; Teodoro J Herbosa; Eric SM Talens; Nicole Rose I Alberto

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Diagnostic accuracy of a near-infrared spectroscopy device for detecting intracranial hemorrhage in mild closed traumatic brain injury at a Philippine Trauma Center.

Author: Brent Andrew G. Viray ¹ ; Halima O. Mokamad-Romancap ² ; Teodoro J. Herbosa ² ; Eric SM. Talens ² ; Nicole Rose I. Alberto ³
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1. Department of Surgery, Philippine General Hospital
2. Division of Trauma Surgery, Department of Surgery, Philippine General Hospital
3. 3 College of Medicine, University of the Philippines Manila
Publication Type:Journal Article
Keywords: near-infrared spectroscopy; intracranial hemorrhage; mild traumatic brain injury
From: Philippine Journal of Surgical Specialties 2022;77(1):1-7
CountryPhilippines
Language:English
Abstract: OBJECTIVE:This study aimed to evaluate the sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, and negative likelihood ratio of a handheld Near Infrared Spectroscopy (NIRS) device (Infrascanner 2000®) in detecting intracranial hemorrhage in mild, closed traumatic brain injury patients in the emergency room setting.
METHODS:This prospective study evaluated the diagnostic validity of a NIRS device in hemodynamically stable patients with mild, closed traumatic brain injury. The authors included patients aged 15 to 65 years who were consecutively admitted to the Emergency Department of the Philippine General Hospital from June 2017 to September 2017. Patients were scanned by a trained research assistant with the NIRS device in the frontal, temporal, parietal, and occipital areas of the brain bilaterally. A cranial computed tomography scan was used as a reference standard for comparison.
RESULTS:A total of 83 participants with mild, closed traumatic brain injury were included in the final analysis. There were 68 (82%) males, and the mean age was 29.52 years old. Of the 83 participants, 41 had intracranial hemorrhages (23 subdural, 13 epidural, 5 intraprenchymal). The NIRS device exhibited a sensitivity, 85.37% [55-96.19%]; specificity, 92.86% [85.07-100.00%]; PPV, 92.12% [83.53-100.00%]; NPV, 86.67% [76.74-96.60%]; PLR, 11.96 [3.99- 35.82]; and NLR, 0.16 [0.07-0.33].
CONCLUSION:The NIRS device can reliably screen for hemorrhages in patients with mild, closed traumatic brain injury using CT scan results as the gold standard. These diagnostic values suggest the potential role of the NIRS device in the early evaluation of patients with traumatic brain injury requiring urgent care.
Full text:Diagnostic accuracy of a near-infrared.pdf