Investigating the relationship and predictive value of NEXUS and MARSHAL criteria in the outcome of head and vertebral co-injury in multiple trauma patients

Abstract

A large part of the patients referred to the hospital are trauma patients, and cervical spine trauma and brain trauma are also common among them. As a result, the aim of this study is to investigate the outcome of brain trauma patients using the Marshall criteria and cervical spine trauma using the NEXUS criteria in order to predict the outcome of patients with simultaneous trauma. Methods: This study is a cross-sectional, descriptive, analysis study in which all multiple trauma patients who entered the emergency department of Imam Reza hospital during the months of July and August of 1403 were included in the study. Patient data was completed based on age and sex, Marshall and NEXUS checklists for each patient, and then according to the hospital protocol, 3-view imaging was performed for the patients, and if there was an indication, a CT scan of the neck was also performed. Then, the outcome of the patients and the way of assigning the patients were noted, which included emergency deaths, deaths in the ward, discharge from the emergency room, and discharge from the ward. Results: Among the participants, the age group of 40-49 years and male gender was the most frequent among patients. All patients underwent brain CT scan. 14 patients (20.3%) were NEXUS negative and 55 cases (79.7%) were NEXUS positive. Pain was the most frequent (18 people, equal to 32.7%) among NEXUS criteria. Examining the results of the Marshall criterion in the participating patients showed that most of the patients had scored 1 (35 equal to 50.7%). 51 people (73.9%) had X-rays taken. In terms of outcome, 35 of the participants (50.7%) were hospitalized and 34 (49.3%) were discharged. The most diagnosis was related to DAI, which was seen in 9 people, equivalent to 25.7% of patients. Marshall's criterion has a significant positive correlation with NEXUS details and diagnosis, and a significant negative correlation with X-ray and outcome (P<0.05). NEXUS criterion has a significant positive correlation with ray variables and outcome (P<0.05).