EBQ:Denver Screening Criteria - Revision history

Danbot: Added all missing standard JC sections

2026-03-21T22:50:16Z

Added all missing standard JC sections

@@ Línea 13: / Línea 13: @@
 *Kerwin et al: Using the above criteria for both symptomatic and asymptomatic patients, found a 44% positive angiography rate in 1941 patients.<ref>Kerwin AJ, Bynoe RP, Murray J et al. Liberalized screening for blunt carotid and vertebral artery injuries is justified. J. Trauma 2001; 51: 308–14.</ref>
 *Fabian et al: Reported a drop in BCI-associated mortality from 24% to 13% after instituting a broad screening protocol.<ref>Fabian TC, Patton JH, Croce MA et al. Blunt carotid injury: importance of early diagnosis and anticoagulant therapy. Ann. Surg.1996; 223: 513–25.</ref>
 ==Validation==

Rossdonaldson1: /* Background */

2015-04-19T23:09:40Z

Background

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	~~==Background==~~		{{Denver screening criteria background}}
	*Used to screen for [[vertebral and carotid artery dissection]] and/or injury after blunt head and neck trauma '''(BCVI - blunt cerebrovascular injury)'''<ref>Bromberg, William. et al. Blunt Cerebrovascular Injury Practice Management Guidelines: The Eastern Association for the Surgery of Trauma. J Trauma. 68 (2): 471-7, Feb 2010. </ref><ref>Cothren CC, Moore EE, Biffl WL, et al. Anticoagulation is the gold standard therapy for blunt carotid injuries to reduce stroke rate. Arch Surg. 2004;139:540–545; discussion 545–546. [http://archsurg.jamanetwork.com/data/Journals/SURG/9575/sws3014.pdf PDF]</ref>
	*A CTA to evaluate for VAI should be obtained in those meeting the modified Denver ~~Criteria~~

	*BCVI has the highest association with cervical hyperextension and rotation, hyperflexion, or direct blunt force to head and neck<ref> Biffl WL, Moore EE, Offner PJ, et al. Optimizing screening ~~for blunt cerebrovascular injuries. Am J Surg. 1999;178:517–522.</ref>~~

	*Most injuries are diagnosed after the development of symptoms secondary to central nervous system ischemia resulting in neurologic morbidity of up to 80% and associated mortality of up to 40%.<ref>Davis JW, Holbrook TL, Hoyt DB, Mackersie RC, Field TO Jr, Shackford SR. Blunt carotid artery dissection: incidence, associated injuries, screening, and treatment. J Trauma. 1990;30:1514–1517</ref>
	~~[[File:BCVI-Algorithm.png\|thumb\|Algorithm for evaluation of BCVI with high risk~~ criteria ~~based on Memphis and Denver Screening Criteria]]~~

	==Clinical Question==		==Clinical Question==

Arsmd at 06:07, 4 April 2015

2015-04-04T06:07:45Z

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	*18% of screened patients had a vascular injury		*18% of screened patients had a vascular injury
	{{Denver Screening Criteria}}		{{Denver Screening Criteria}}


			*Kerwin et al: Using the above criteria for both symptomatic and asymptomatic patients, found a 44% positive angiography rate in 1941 patients.<ref>Kerwin AJ, Bynoe RP, Murray J et al. Liberalized screening for blunt carotid and vertebral artery injuries is justified. J. Trauma 2001; 51: 308–14.</ref>
			*Fabian et al: Reported a drop in BCI-associated mortality from 24% to 13% after instituting a broad screening protocol.<ref>Fabian TC, Patton JH, Croce MA et al. Blunt carotid injury: importance of early diagnosis and anticoagulant therapy. Ann. Surg.1996; 223: 513–25.</ref>

	==Validation==		==Validation==

DrJeffRogers: /* Criteria */

2015-03-28T20:54:50Z

Criteria

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 *5% of trauma patients were screened
 *18% of screened patients had a vascular injury
-==Criteria==
+{{Denver Screening Criteria}}
 ==Validation==

Rossdonaldson1: /* Background */

2015-01-27T08:47:28Z

Background

← Revisión anterior		Revisión del 08:47 27 ene 2015
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	==Background==		==Background==
	*Used to screen for ~~injury to the~~ carotid or ~~vertebral vessels~~ after blunt head and neck trauma '''(BCVI - blunt cerebrovascular injury)'''<ref>Bromberg, William. et al. Blunt Cerebrovascular Injury Practice Management Guidelines: The Eastern Association for the Surgery of Trauma. J Trauma. 68 (2): 471-7, Feb 2010. </ref><ref>Cothren CC, Moore EE, Biffl WL, et al. Anticoagulation is the gold standard therapy for blunt carotid injuries to reduce stroke rate. Arch Surg. 2004;139:540–545; discussion 545–546. [http://archsurg.jamanetwork.com/data/Journals/SURG/9575/sws3014.pdf PDF]</ref>		*Used to screen for [[vertebral and carotid artery dissection]] and/or injury after blunt head and neck trauma '''(BCVI - blunt cerebrovascular injury)'''<ref>Bromberg, William. et al. Blunt Cerebrovascular Injury Practice Management Guidelines: The Eastern Association for the Surgery of Trauma. J Trauma. 68 (2): 471-7, Feb 2010. </ref><ref>Cothren CC, Moore EE, Biffl WL, et al. Anticoagulation is the gold standard therapy for blunt carotid injuries to reduce stroke rate. Arch Surg. 2004;139:540–545; discussion 545–546. [http://archsurg.jamanetwork.com/data/Journals/SURG/9575/sws3014.pdf PDF]</ref>
	*A CTA to evaluate for VAI should be obtained in those meeting the modified Denver Criteria		*A CTA to evaluate for VAI should be obtained in those meeting the modified Denver Criteria

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	*Most injuries are diagnosed after the development of symptoms secondary to central nervous system ischemia resulting in neurologic morbidity of up to 80% and associated mortality of up to 40%.<ref>Davis JW, Holbrook TL, Hoyt DB, Mackersie RC, Field TO Jr, Shackford SR. Blunt carotid artery dissection: incidence, associated injuries, screening, and treatment. J Trauma. 1990;30:1514–1517</ref>		*Most injuries are diagnosed after the development of symptoms secondary to central nervous system ischemia resulting in neurologic morbidity of up to 80% and associated mortality of up to 40%.<ref>Davis JW, Holbrook TL, Hoyt DB, Mackersie RC, Field TO Jr, Shackford SR. Blunt carotid artery dissection: incidence, associated injuries, screening, and treatment. J Trauma. 1990;30:1514–1517</ref>
	[[File:BCVI-Algorithm.png\|thumb\|Algorithm for evaluation of BCVI with high risk criteria based on Memphis and Denver Screening Criteria]]		[[File:BCVI-Algorithm.png\|thumb\|Algorithm for evaluation of BCVI with high risk criteria based on Memphis and Denver Screening Criteria]]

	==Clinical Question==		==Clinical Question==
	*Can clinical criteria and injury profile and risk factors successfully identify patients at risk for BCVI?		*Can clinical criteria and injury profile and risk factors successfully identify patients at risk for BCVI?

Rossdonaldson1: /* See Also */

2015-01-27T08:46:52Z

Rossdonaldson1: /* See Also */

2015-01-27T08:44:57Z

Ostermayer at 14:16, 13 November 2014

2014-11-13T14:16:11Z

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	<references/>		<references/>

	[[Category:Trauma]][[Category:EBQ]]		[[Category:Trauma]][[Category:EBQ]][[Category:Featured]]

Ostermayer: /* Validation */

2014-11-12T04:08:57Z

Validation

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 ==Validation==
 *The Denver Criteria has not been externally validated
 ==See Also==
 {{Head Neck Trauma}}

Ostermayer: /* Risk Factors */

2014-11-12T04:02:14Z

Risk Factors

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	===Risk Factors===		===Risk Factors===
	*[[Le Fort fractures]]		*[[Le Fort fractures\|Midface Fractures]]
	*[[Cervical Spine Injuries]]		*[[Cervical Spine Injuries]]
	*Basilar Skull Fracture		*Basilar Skull Fracture
	*GCS<8		*GCS<8
	*Hanging with Anoxic Brain Injury		*Hanging with Anoxic Brain Injury
			*Seat belt abrasion or other soft tissue injury of the anterior neck resulting in significant swelling or altered mental status
			**Isolated seatbelt sign without other neurologic symptoms has not been identified as a risk factor<ref>DiPerna CA, Rowe VL, Terramani TT, et al. Clinical importance of the “seat belt sign” in blunt trauma to the neck. Am Surg. 2002;68:441–445</ref><ref>Rozycki GS, Tremblay L, Feliciano DV, et al. A prospective study for the detection of vascular injury in adult and pediatric patients with cervicothoracic seat belt signs. J Trauma. 2002;52:618–623; discussion 623–624</ref>

	==Validation==		==Validation==

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	==See Also==		==See Also==
	*[[Blunt neck trauma]]		*[[Blunt neck trauma]]
			*[[Vertebral and carotid artery dissection]]

	==Sources==		==Sources==

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	==See Also==		==See Also==
	~~{{Head Neck Trauma}}~~		*[[Blunt neck trauma]]

	==Sources==		==Sources==