التفاصيل البيبلوغرافية
| العنوان: |
Implementation of the Ottawa ankle rules by general practitioners in the emergency department of a Turkish district hospital. |
| Alternate Title: |
Ottawa ayak bileği kurallarının ülkemizde devlet hastanesi acil servisinde görevli pratisyen hekimler tarafınca kullanımı. (Turkish) |
| المؤلفون: |
Daş, Murat, Temiz, Aytun, Çevik, Yunsur |
| المصدر: |
Turkish Journal of Trauma & Emergency Surgery / Ulusal Travma ve Acil Cerrahi Dergisi; Jul2016, Vol. 22 Issue 4, p361-364, 4p |
| مصطلحات موضوعية: |
DIAGNOSIS of bone fractures, ANKLE injuries, FOOT injuries, HOSPITAL emergency services, HOSPITAL health promotion programs, GENERAL practitioners, HUMAN services programs |
| مصطلحات جغرافية: |
CANADA |
| Abstract (English): |
BACKGROUND: The present objective was to assess implementation of the Ottawa ankle rules (OAR) as a method of fracture prediction in the emergency department (ED) of a Turkish state hospital. METHODS: Patients who presented to the ED of our hospital with acute ankle injury were evaluated. All were examined by a general practitioner, after which a series of ankle and foot x-rays (anteroposterior and lateral) were performed. Radiography was examined by a radiologist and an orthopedic surgeon, both of whom were blinded to OAR results. Radiographic results were compared to results of OAR implementation. Sensitivity and specificity of the OAR in the diagnosis of fracture was calculated. RESULTS: A total of 251 (61.97%) patients were diagnosed as positive (+) for fracture after OAR implementation, 154 (38.02%) as negative (-). Clinically significant fracture was detected in 62 (15.3%) patients. A total of 61 (98.4%) patients with significant fracture were OAR (+); I (1.6%) was OAR (-). However, 190 (55.4%) patients without fracture were OAR (+); 153 (44.6%) were OAR (-) (p<0.00l). Sensitivity, specificity, and positive and negative predictive values of OAR implementation in the prediction of fracture were 98.39%, 44.61%, 24.30%, and 99.35%, respectively. Area under the curve (AUC) was 0.71. According to these results, it was determined that use of radiography could be reduced by 38.02% if the OAR were implemented. CONCLUSION: The OAR are a highly sensitive means of screening of patients with acute ankle and mid-foot injuries. Application of the OAR by well-trained general practitioners can lead to significant reduction in the number of x-rays performed, thereby reducing cost of treatment and radiation exposure, in addition to saving time for patients and staff. [ABSTRACT FROM AUTHOR] |
| Abstract (Turkish): |
AMAÇ: Ottawa ayak bileği kurallarının ülkemizde devlet hastanesinde görevli pratisyen hekimler tarafınca kullanılmasının etkinliğini araştırmak. GEREÇ VE YÖNTEM: iki yüz yataklı devlet hastanesi ikinci basamak acil servise, ayak-ayakbileği travması ile müracaat eden 405 hasta çalışmaya dahil edildi. Tüm hastalar pratisyen hekim tarafınca muayene edilerek Ottawa pozitif veya negatif olarak sınıflandırıldı. Tüm hastalara ön-arka ve yan, ayak ve ayak bileği grafisi çekildi. Grafiler, hastanın Ottawa grubunu bilmeyen ortopedi ve radyoloji uzmanlarınca değerlendirilerek klinik olarak anlamlı kırık olup olmadığı saptandı. Takiben sonuca göre Ottawa ayakbileği kuralı için duyarlılık, özgüllük, pozitif ve negatif kestirim değerleri hesaplandı. BULGULAR: iki yüz elli bir (%61.97) hasta Ottawa (+), 154 hasta (%38.02) Ottawa (-) olarak saptandı. Altmış iki (% 15.3) hastada klinik olarak anlamlı kırık tespit edildi. Kırık olan 62 hastanın 61 'inde (%98.4) Ottawa (+) idi. Deplase olmamış birinci metatars kırığı tespit edilen bir (% 1.6) hastada Ottawa (-) idi. Bununla birlikte kırık saptanmayan 190 (%55.4) hasta Ottawa (+), I53 (%44.6) hasta Ottawa (-) idi (p<0.001). Duyarlılık, özgüllük, pozitif ve negatif kestirim değerleri sırasıyla %98.39, %44.61, %24.30 ve %99.35 idi. Eğri altında kalan alan 0.71 olarak hesaplandı. Bu sonuçlara göre Ottawa ayakbileği kurallarının olası radyolojik tetkik azaltma oranı %38.02 olarak tespit edildi. TARTIŞMA: Ottawa ayak bileği kuralları (OAR) akut ayak bileği ve ayak orta bölüm yaralanmaları geçiren hastalarda yüksek derecede duyarlı tarama testidir, iyi eğitimli pratisyen hekimlerin OAR'yi uygulaması çekilen radyogramların sayısının anlamlı derecede azalmasını sağlayarak, hasta ve personelin zamandan tasarruf sağlamasına ek olarak tedavi maliyetini ve radyasyona maruziyeti de azaltır. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |