A study with a major methodological flaw erroneously concluded that the NEXUS rule was highly sensitive for detecting cervical spine injury among patients 65 and older.
The North American X-Radiography Utilizations Study (NEXUS) cervical spine rule indicates that cervical spine radiography is not necessary for trauma patients with normal mental status, no distracting injury, no midline cervical spine tenderness, and no focal neurological deficit. Its applicability to patients aged >64 years has been questioned.
To assess the NEXUS criteria's sensitivity for identifying fall victims aged >64 who do not require cervical radiography, investigators reviewed registry data from a single Level 1 trauma center.
Of 647 patients who presented with falls (median age, 81), 8% had a cervical spine or cord injury. Of these, 100% were reportedly detected by the NEXUS criteria.
Reviewing Author
DisclosuresConsultant/Advisory BoardPortola Pharmaceuticals, Inc.
Speaker’s BureauPeerView Institute for Medical Education
Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals
DisclosuresConsultant/Advisory BoardPortola Pharmaceuticals, Inc.
Speaker’s BureauPeerView Institute for Medical Education
Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals