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Malaysian Journal of Medical Sciences
School of Medical Sciences, Universiti Sains Malaysia
ISSN: 1394-195X
Vol. 19, No. 3, 2012, pp. 64-68
Bioline Code: mj12038
Full paper language: English
Document type: Short Communication
Document available free of charge

Malaysian Journal of Medical Sciences, Vol. 19, No. 3, 2012, pp. 64-68

 en Mild Paediatric Head Injury: The Diagnostic Value of Physical Examinations Compared with Computed Tomographic Scans
Farizal , Farizal & Haspani, Mohd Safari Mohd

Abstract

The study objective was to determine the diagnostic value of physical examinations for positive computer tomography (CT) scans in children with mild head injuries. Retrospective data of patients evaluated for mild head injuries with loss of consciousness (LOC) or amnesia were reviewed. Estimations of prevalence, sensitivity, specificity, and predictive values were calculated. Agreement between the physical examinations and CT brain scans was calculated using the Kappa test. 225 patients were included in the study. Of this group, 19.56% of patients had positive CT scans, and 7.56% had normal physical examinations. 15 underwent neurosurgical intervention. For positive CT scans, sensitivity and specificity were 61.36% and 60.22%, respectively. Agreement between physical examinations and CT scans was Kappa = 0.147 (P < 0.05), 95% CI (0.035, 0.259). The present study demonstrated that physical examinations were significantly associated with positive CT scans (P = 0.01). However, the calculated Kappa value showed only slight agreement between these 2 variables, and the low sensitivity and specificity of the physical examinations suggest that intracranial pathology in children with mild head injuries and LOC or amnesia cannot be excluded based on physical examinations alone.

Keywords
CT scan, diagnostic value, mild head injury, physical examination, sensitivity, specificity

 
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Alternative site location: http://www.medic.usm.my/publication/mjms/

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