LP or not LP, that is the question: gold standard or unnecessary procedure in subarachnoid haemorrhage?

2.50
Hdl Handle:
http://hdl.handle.net/11287/593790
Title:
LP or not LP, that is the question: gold standard or unnecessary procedure in subarachnoid haemorrhage?
Authors:
Stewart, H.; Reuben, Adam; McDonald, J.
Abstract:
OBJECTIVE: To measure the sensitivity of modern CT in patients presenting to the emergency department and evaluated for possible subarachnoid haemorrhage, with particular attention to those presenting within 12 h of ictus. DESIGN: Retrospective cohort study. SETTING: Large district general hospital emergency department seeing 73,500 new attendances per year. PARTICIPANTS: Patients presenting to the emergency department and screened for suspected subarachnoid haemorrhage. OUTCOME MEASURES: Subarachnoid haemorrhage was defined by either the presence of subarachnoid blood on CT, positive CSF spectrophotometry defined by national guidelines or aneurysm identified on subsequent angiography if either of the former were equivocal. RESULTS: 244 patients were screened for subarachnoid haemorrhage during the 24 months between March 2006 and April 2008 (mean age 48.5 years). The sensitivity of CT overall for subarachnoid haemorrhage was 93.8% (95% CI 84% to 98%) increasing to 95% (95% CI 82% to 99%) if performed within 12 h of ictus. CONCLUSIONS: While modern CT has a high sensitivity for the diagnosis of acute subarachnoid haemorrhage, particularly within 12 h of ictus, it is still not sufficient to act as the sole diagnostic tool, and patients with a negative CT will require further investigation with a lumbar puncture.
Citation:
Emerg Med J. 2014 Sep;31(9):720-3.
Publisher:
BMJ
Journal:
Emergency medicine journal : EMJ
Issue Date:
1-Sep-2014
URI:
http://hdl.handle.net/11287/593790
DOI:
10.1136/emermed-2013-202573
PubMed ID:
23756363
Additional Links:
http://emj.bmj.com/cgi/pmidlookup?view=long&pmid=23756363
Note:
RD&E staff can access the full-text of this article by clicking on the 'Additional Link' above and logging in with NHS OpenAthens if prompted.
Type:
Journal Article
Language:
eng
ISSN:
1472-0213
Appears in Collections:
Emergency Department; 2014 RD&E publications

Full metadata record

DC FieldValue Language
dc.contributor.authorStewart, H.en
dc.contributor.authorReuben, Adamen
dc.contributor.authorMcDonald, J.en
dc.date.accessioned2016-01-19T12:34:57Zen
dc.date.available2016-01-19T12:34:57Zen
dc.date.issued2014-09-01en
dc.identifier.citationEmerg Med J. 2014 Sep;31(9):720-3.en
dc.identifier.issn1472-0213en
dc.identifier.pmid23756363en
dc.identifier.doi10.1136/emermed-2013-202573en
dc.identifier.urihttp://hdl.handle.net/11287/593790en
dc.description.abstractOBJECTIVE: To measure the sensitivity of modern CT in patients presenting to the emergency department and evaluated for possible subarachnoid haemorrhage, with particular attention to those presenting within 12 h of ictus. DESIGN: Retrospective cohort study. SETTING: Large district general hospital emergency department seeing 73,500 new attendances per year. PARTICIPANTS: Patients presenting to the emergency department and screened for suspected subarachnoid haemorrhage. OUTCOME MEASURES: Subarachnoid haemorrhage was defined by either the presence of subarachnoid blood on CT, positive CSF spectrophotometry defined by national guidelines or aneurysm identified on subsequent angiography if either of the former were equivocal. RESULTS: 244 patients were screened for subarachnoid haemorrhage during the 24 months between March 2006 and April 2008 (mean age 48.5 years). The sensitivity of CT overall for subarachnoid haemorrhage was 93.8% (95% CI 84% to 98%) increasing to 95% (95% CI 82% to 99%) if performed within 12 h of ictus. CONCLUSIONS: While modern CT has a high sensitivity for the diagnosis of acute subarachnoid haemorrhage, particularly within 12 h of ictus, it is still not sufficient to act as the sole diagnostic tool, and patients with a negative CT will require further investigation with a lumbar puncture.en
dc.language.isoengen
dc.publisherBMJen
dc.relation.urlhttp://emj.bmj.com/cgi/pmidlookup?view=long&pmid=23756363en
dc.titleLP or not LP, that is the question: gold standard or unnecessary procedure in subarachnoid haemorrhage?en
dc.typeJournal Articleen
dc.identifier.journalEmergency medicine journal : EMJen
dc.description.noteRD&E staff can access the full-text of this article by clicking on the 'Additional Link' above and logging in with NHS OpenAthens if prompted.en
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