![]() In the only trial to undertake a prospective head to head comparison of NEXUS to the CCR, the CCR was found to have superior sensitivity (99.4 vs 90.7%).However, there is literature to suggest caution applying NEXUS to patients > 65 years of age, as the sensitivity may be as low as 66-84%. In a large retrospective trauma registry study of 231,018 patients by Paykin et al in 2017, sensitivity was still only 94.8% (95% CI: 92.1%-96.7%). Unlike the Canadian C-spine Rule (CCR), NEXUS Criteria does not have age cut-offs and is theoretically applicable to all patients > 1 year of age.Subsequent studies have found a sensitivity of 83-100% for CSI with majority finding 90-100% sensitivity.Adopting this rule could decrease imaging in these patients by 12.6%.Also detected 99.0% (8/818) of ALL c-spine injuries (6 of which were injuries that didn’t require stabilization or specialized treatment).NEXUS Criteria found to have sensitivity of 99.6% for ruling out CSI (2/578). 1.7% of those studied had clinically significant c-spine injuries (CSI). Validation study included a prospective, observational sample of 34,069 patients, aged 1 to 101 years, presenting to 21 US trauma centers.The NEXUS Criteria were developed to help physicians determine whether cervical spine imaging could be safely avoided in appropriate patients.
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