Near-infrared spectroscopy (NIRS) to detect traumatic intracranial haematoma: A systematic review and meta-analysis

Objectives and Methods: Head injury is the most common trauma presentation to UK emergency departments, with around 1.2 million patients each year. The key management principal for this time critical illness remains early surgical intervention. With the development of handheld near-infrared spectros...

Full description

Saved in:
Bibliographic Details
Published in:Brain injury 2017-04, Vol.31 (5), p.581-588
Main Authors: Brogan, Robert J., Kontojannis, Vassilios, Garara, Bhavin, Marcus, Hani J., Wilson, Mark H.
Format: Article
Language:English
Subjects:
head trauma
Humans
intracranial haematoma
intracranial haemorrhage
Intracranial Hemorrhage, Traumatic - diagnosis
near-infrared spectroscopy
Sensitivity and Specificity
Spectroscopy, Near-Infrared - methods
Traumatic brain injury
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Objectives and Methods: Head injury is the most common trauma presentation to UK emergency departments, with around 1.2 million patients each year. The key management principal for this time critical illness remains early surgical intervention. With the development of handheld near-infrared spectroscopy (NIRS) devices, there is now the possibility of triaging and diagnosing these patients immediately, where computed tomography (CT) scanner is unavailable. NIRS has two related but distinct potential uses within clinical medicine. Firstly, as a triage tool both in hospital and prehospital settings by doctors, nurses or paramedics as determined by its negative predictive value (NPV). Secondly, as a diagnostic aid as determined by its positive predictive value (PPV). The aim of this systematic review and meta-analysis is therefore to interrogate the current literature on NIRS in detecting intracranial haematomas.Results: NIRS technology has a cross-study sensitivity of 78%, specificity of 90%, PPV of 77%, and a NPV of 90%, which does not meet current standards as a diagnostic/triage tool in the populations studied. Additionally, its use is limited to those without extracranial injuries and may also be complicated by long scan times.Conclusion: Larger and more heterogeneous studies are required for specifically evaluating NIRS performance in detecting intracranial lesions requiring emergency evacuation.
ISSN:0269-9052
1362-301X
DOI:10.1080/02699052.2017.1287956