1.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
Philippine Journal of Surgical Specialties 2022;77(1):1-7
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.