A clinical decision rule to predict zygomatico-maxillary fractures
Abstract Patients presenting with periorbital trauma require clinical assessment to exclude zygomatico-maxillary fractures. A single-centre pilot investigation was undertaken at a general hospital in the United Kingdom. The sample was composed of 229 adult patients attending our emergency department...
Gespeichert in:
| Veröffentlicht in: | Journal of cranio-maxillo-facial surgery 2017-08, Vol.45 (8), p.1333-1337 |
|---|---|
| Hauptverfasser: | , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1337 |
|---|---|
| container_issue | 8 |
| container_start_page | 1333 |
| container_title | Journal of cranio-maxillo-facial surgery |
| container_volume | 45 |
| creator | Haworth, Simon Bates, Anthony Beech, Andrea Knepil, Greg |
| description | Abstract Patients presenting with periorbital trauma require clinical assessment to exclude zygomatico-maxillary fractures. A single-centre pilot investigation was undertaken at a general hospital in the United Kingdom. The sample was composed of 229 adult patients attending our emergency department with periorbital injuries. Findings from 17 signs or symptoms of facial injury were recorded on a validated tool. The relationship between clinical presentation and displaced zygomatico-maxillary fracture was assessed using diagnostic test parameters and tests for correlation. A decision-making rule was derived. The presence of a) palpable bony step, b) bony asymmetry, c) lateral sub-conjunctival haemorrhage with no posterior limit, d) anaesthesia or paraesthesia to lip/cheek or side of nose and e) palpable emphysema were all specific features of radiographically displaced zygomatico-maxillary fracture (specificity all >75.0 %, p value for correlation all |
| doi_str_mv | 10.1016/j.jcms.2017.05.016 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1913832168</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S1010518217301725</els_id><sourcerecordid>1913832168</sourcerecordid><originalsourceid>FETCH-LOGICAL-c455t-33ce8572d4cc02ad25a3c76f201898d7b6dc8ee9770837ef2a368d395cad36243</originalsourceid><addsrcrecordid>eNp9kUtr3TAQhUVoSNK0fyCL4mU3dvSwHoZSSEIfgUAXbddCGY2DXNu6lezQ219fmZt00UVXEsM5hzPfEHLBaMMoU5dDM8CUG06ZbqhsyuiInDGjTd0y1r0of8poLZnhp-RlzgOlVFHTnZBTblSrmaJn5PqqgjHMAdxYeYSQQ5yrtI5YLbHaJfQBlur3_iFObgkQ68n9CuPo0r7qk4NlTZhfkePejRlfP73n5PvHD99uPtd3Xz7d3lzd1dBKudRCABqpuW8BKHeeSydAq77UN53x-l55MIid1tQIjT13QhkvOgnOC8VbcU7eHnJ3Kf5cMS92ChmwtJkxrtmyjgkjOFOmSPlBCinmnLC3uxSm0toyajd2drAbO7uxs1TaMiqmN0_56_2E_q_lGVYRvDsIsGz5GDDZDAFnKJASwmJ9DP_Pf_-P_Zn8D9xjHuKa5sLPMpu5pfbrdr3teEyLksKl-APz65SA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1913832168</pqid></control><display><type>article</type><title>A clinical decision rule to predict zygomatico-maxillary fractures</title><source>MEDLINE</source><source>ScienceDirect Journals (5 years ago - present)</source><creator>Haworth, Simon ; Bates, Anthony ; Beech, Andrea ; Knepil, Greg</creator><creatorcontrib>Haworth, Simon ; Bates, Anthony ; Beech, Andrea ; Knepil, Greg</creatorcontrib><description>Abstract Patients presenting with periorbital trauma require clinical assessment to exclude zygomatico-maxillary fractures. A single-centre pilot investigation was undertaken at a general hospital in the United Kingdom. The sample was composed of 229 adult patients attending our emergency department with periorbital injuries. Findings from 17 signs or symptoms of facial injury were recorded on a validated tool. The relationship between clinical presentation and displaced zygomatico-maxillary fracture was assessed using diagnostic test parameters and tests for correlation. A decision-making rule was derived. The presence of a) palpable bony step, b) bony asymmetry, c) lateral sub-conjunctival haemorrhage with no posterior limit, d) anaesthesia or paraesthesia to lip/cheek or side of nose and e) palpable emphysema were all specific features of radiographically displaced zygomatico-maxillary fracture (specificity all >75.0 %, p value for correlation all <0.001). A decision-making rule based on the presence of any one of features (a),(c),(d) or (e) identified all patients with displaced zygomatico-maxillary fractures in this sample (sensitivity 100% (95% CI 93.4%–100.0%), specificity 72.6% (95% CI 65.3%–79.0%). Implementation of this clinical decision-making rule would identify all patients with displaced fractures at the triage stage whilst reducing radiographic exposures by 55% in this sample.</description><identifier>ISSN: 1010-5182</identifier><identifier>EISSN: 1878-4119</identifier><identifier>DOI: 10.1016/j.jcms.2017.05.016</identifier><identifier>PMID: 28647160</identifier><language>eng</language><publisher>Scotland: Elsevier Ltd</publisher><subject>Adult ; Clinical decision rules ; Clinical Decision-Making ; Clinical examination ; Dentistry ; Facial trauma ; Humans ; Maxillary Fractures - diagnosis ; Pilot Projects ; Radiographic examination ; Retrospective Studies ; Surgery ; Symptom Assessment ; Zygomatic fractures ; Zygomatic Fractures - diagnosis ; Zygomatico-maxillary fractures</subject><ispartof>Journal of cranio-maxillo-facial surgery, 2017-08, Vol.45 (8), p.1333-1337</ispartof><rights>European Association for Cranio-Maxillo-Facial Surgery</rights><rights>2017 European Association for Cranio-Maxillo-Facial Surgery</rights><rights>Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c455t-33ce8572d4cc02ad25a3c76f201898d7b6dc8ee9770837ef2a368d395cad36243</citedby><cites>FETCH-LOGICAL-c455t-33ce8572d4cc02ad25a3c76f201898d7b6dc8ee9770837ef2a368d395cad36243</cites><orcidid>0000-0001-7793-7326 ; 0000-0003-3688-9887</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jcms.2017.05.016$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28647160$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Haworth, Simon</creatorcontrib><creatorcontrib>Bates, Anthony</creatorcontrib><creatorcontrib>Beech, Andrea</creatorcontrib><creatorcontrib>Knepil, Greg</creatorcontrib><title>A clinical decision rule to predict zygomatico-maxillary fractures</title><title>Journal of cranio-maxillo-facial surgery</title><addtitle>J Craniomaxillofac Surg</addtitle><description>Abstract Patients presenting with periorbital trauma require clinical assessment to exclude zygomatico-maxillary fractures. A single-centre pilot investigation was undertaken at a general hospital in the United Kingdom. The sample was composed of 229 adult patients attending our emergency department with periorbital injuries. Findings from 17 signs or symptoms of facial injury were recorded on a validated tool. The relationship between clinical presentation and displaced zygomatico-maxillary fracture was assessed using diagnostic test parameters and tests for correlation. A decision-making rule was derived. The presence of a) palpable bony step, b) bony asymmetry, c) lateral sub-conjunctival haemorrhage with no posterior limit, d) anaesthesia or paraesthesia to lip/cheek or side of nose and e) palpable emphysema were all specific features of radiographically displaced zygomatico-maxillary fracture (specificity all >75.0 %, p value for correlation all <0.001). A decision-making rule based on the presence of any one of features (a),(c),(d) or (e) identified all patients with displaced zygomatico-maxillary fractures in this sample (sensitivity 100% (95% CI 93.4%–100.0%), specificity 72.6% (95% CI 65.3%–79.0%). Implementation of this clinical decision-making rule would identify all patients with displaced fractures at the triage stage whilst reducing radiographic exposures by 55% in this sample.</description><subject>Adult</subject><subject>Clinical decision rules</subject><subject>Clinical Decision-Making</subject><subject>Clinical examination</subject><subject>Dentistry</subject><subject>Facial trauma</subject><subject>Humans</subject><subject>Maxillary Fractures - diagnosis</subject><subject>Pilot Projects</subject><subject>Radiographic examination</subject><subject>Retrospective Studies</subject><subject>Surgery</subject><subject>Symptom Assessment</subject><subject>Zygomatic fractures</subject><subject>Zygomatic Fractures - diagnosis</subject><subject>Zygomatico-maxillary fractures</subject><issn>1010-5182</issn><issn>1878-4119</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kUtr3TAQhUVoSNK0fyCL4mU3dvSwHoZSSEIfgUAXbddCGY2DXNu6lezQ219fmZt00UVXEsM5hzPfEHLBaMMoU5dDM8CUG06ZbqhsyuiInDGjTd0y1r0of8poLZnhp-RlzgOlVFHTnZBTblSrmaJn5PqqgjHMAdxYeYSQQ5yrtI5YLbHaJfQBlur3_iFObgkQ68n9CuPo0r7qk4NlTZhfkePejRlfP73n5PvHD99uPtd3Xz7d3lzd1dBKudRCABqpuW8BKHeeSydAq77UN53x-l55MIid1tQIjT13QhkvOgnOC8VbcU7eHnJ3Kf5cMS92ChmwtJkxrtmyjgkjOFOmSPlBCinmnLC3uxSm0toyajd2drAbO7uxs1TaMiqmN0_56_2E_q_lGVYRvDsIsGz5GDDZDAFnKJASwmJ9DP_Pf_-P_Zn8D9xjHuKa5sLPMpu5pfbrdr3teEyLksKl-APz65SA</recordid><startdate>20170801</startdate><enddate>20170801</enddate><creator>Haworth, Simon</creator><creator>Bates, Anthony</creator><creator>Beech, Andrea</creator><creator>Knepil, Greg</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-7793-7326</orcidid><orcidid>https://orcid.org/0000-0003-3688-9887</orcidid></search><sort><creationdate>20170801</creationdate><title>A clinical decision rule to predict zygomatico-maxillary fractures</title><author>Haworth, Simon ; Bates, Anthony ; Beech, Andrea ; Knepil, Greg</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c455t-33ce8572d4cc02ad25a3c76f201898d7b6dc8ee9770837ef2a368d395cad36243</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Clinical decision rules</topic><topic>Clinical Decision-Making</topic><topic>Clinical examination</topic><topic>Dentistry</topic><topic>Facial trauma</topic><topic>Humans</topic><topic>Maxillary Fractures - diagnosis</topic><topic>Pilot Projects</topic><topic>Radiographic examination</topic><topic>Retrospective Studies</topic><topic>Surgery</topic><topic>Symptom Assessment</topic><topic>Zygomatic fractures</topic><topic>Zygomatic Fractures - diagnosis</topic><topic>Zygomatico-maxillary fractures</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Haworth, Simon</creatorcontrib><creatorcontrib>Bates, Anthony</creatorcontrib><creatorcontrib>Beech, Andrea</creatorcontrib><creatorcontrib>Knepil, Greg</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of cranio-maxillo-facial surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Haworth, Simon</au><au>Bates, Anthony</au><au>Beech, Andrea</au><au>Knepil, Greg</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A clinical decision rule to predict zygomatico-maxillary fractures</atitle><jtitle>Journal of cranio-maxillo-facial surgery</jtitle><addtitle>J Craniomaxillofac Surg</addtitle><date>2017-08-01</date><risdate>2017</risdate><volume>45</volume><issue>8</issue><spage>1333</spage><epage>1337</epage><pages>1333-1337</pages><issn>1010-5182</issn><eissn>1878-4119</eissn><abstract>Abstract Patients presenting with periorbital trauma require clinical assessment to exclude zygomatico-maxillary fractures. A single-centre pilot investigation was undertaken at a general hospital in the United Kingdom. The sample was composed of 229 adult patients attending our emergency department with periorbital injuries. Findings from 17 signs or symptoms of facial injury were recorded on a validated tool. The relationship between clinical presentation and displaced zygomatico-maxillary fracture was assessed using diagnostic test parameters and tests for correlation. A decision-making rule was derived. The presence of a) palpable bony step, b) bony asymmetry, c) lateral sub-conjunctival haemorrhage with no posterior limit, d) anaesthesia or paraesthesia to lip/cheek or side of nose and e) palpable emphysema were all specific features of radiographically displaced zygomatico-maxillary fracture (specificity all >75.0 %, p value for correlation all <0.001). A decision-making rule based on the presence of any one of features (a),(c),(d) or (e) identified all patients with displaced zygomatico-maxillary fractures in this sample (sensitivity 100% (95% CI 93.4%–100.0%), specificity 72.6% (95% CI 65.3%–79.0%). Implementation of this clinical decision-making rule would identify all patients with displaced fractures at the triage stage whilst reducing radiographic exposures by 55% in this sample.</abstract><cop>Scotland</cop><pub>Elsevier Ltd</pub><pmid>28647160</pmid><doi>10.1016/j.jcms.2017.05.016</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0001-7793-7326</orcidid><orcidid>https://orcid.org/0000-0003-3688-9887</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1010-5182 |
| ispartof | Journal of cranio-maxillo-facial surgery, 2017-08, Vol.45 (8), p.1333-1337 |
| issn | 1010-5182 1878-4119 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1913832168 |
| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Adult Clinical decision rules Clinical Decision-Making Clinical examination Dentistry Facial trauma Humans Maxillary Fractures - diagnosis Pilot Projects Radiographic examination Retrospective Studies Surgery Symptom Assessment Zygomatic fractures Zygomatic Fractures - diagnosis Zygomatico-maxillary fractures |
| title | A clinical decision rule to predict zygomatico-maxillary fractures |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-08T00%3A52%3A55IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20clinical%20decision%20rule%20to%20predict%20zygomatico-maxillary%20fractures&rft.jtitle=Journal%20of%20cranio-maxillo-facial%20surgery&rft.au=Haworth,%20Simon&rft.date=2017-08-01&rft.volume=45&rft.issue=8&rft.spage=1333&rft.epage=1337&rft.pages=1333-1337&rft.issn=1010-5182&rft.eissn=1878-4119&rft_id=info:doi/10.1016/j.jcms.2017.05.016&rft_dat=%3Cproquest_cross%3E1913832168%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1913832168&rft_id=info:pmid/28647160&rft_els_id=S1010518217301725&rfr_iscdi=true |