Diagnostic properties of a portable near-infrared spectroscopy to detect intracranial hematoma in traumatic brain injury patients

Abstract

Traumatic brain injury (TBI) is a major public health issue worldwide. A portable near-infrared spectroscopy (NIRS) is a non-invasive device to detect intracranial hematoma. The advantages of the NIRS include real time results and non-radiation exposure. However, sensitivity and specificity of the NIRS for intracranial hematoma are varied. This study aimed to evaluate the diagnostic properties of the NIRS in TBI patients to detect intracranial hematoma. This study was a diagnostic and prospective study conducted at the Emergency Department. The inclusion criteria were adult patients (age of 18 years or over) with moderate to high risk of all degrees of traumatic brain injury within 24 h after the injury. The primary endpoint of the study was a description of diagnostic properties of the NIRS compared with the CT brain. There were 47 patients enrolled in the study. Most of patients had Glasgow Coma Scale of 15 (44 patients; 93.62 %). Of those, 11 patients (23.40 %) had intracranial hematoma: subdural hematoma (n = 9), epidural hematoma (n = 1), intracerebral hematoma (n = 1), and subarachnoid hemorrhage (n = 3). One patient had subdural hematoma, epidural hematoma, intracerebral hematoma and subarachnoid hemorrhage. There were 31 patients had abnormal findings by the NIRS but only 11 patients had bleeding detected by the CT brain. There were 16 patients had negative results on both the NIRS and the CT brain. The sensitivity and specificity of the NIRS compared with the CT brain was 100 % and 44.4 %, respectively. The area under the ROC curve of the NIRS was 0.722. The median time to complete the NIRS examination was 3 min. In conclusion, the NIRS has high sensitivity and negative predictive value for intracranial hematoma detection in mild TBI patients with extra-axial hematomas.