No registrations found.
ID
Source
Brief title
Health condition
polsfractuur, distale radius, klinische beslisregel, kinderen
wrist fracture, distal radius, clinical decision rule, children
Sponsors and support
Intervention
Outcome measures
Primary outcome
The number of requested X-rays in children with acute injury of the wrist after implementation of the AWR.
Secondary outcome
- The number of clinically relevant missed fractures of the distal radius and distal ulna in children after implementation of the AWR
- The reduction of overall waiting time at the ED
- Cost-effectiveness of the AWR
Background summary
Almost every child who sustains wrist trauma is referred for radiological examination to rule out a wrist fracture. However, around 50% of these X-rays do not show a fracture. The Amsterdam Paediatric Wrist Rule is an externally validated clinical decision rule, based on clinical parameters, which helps determine the need for radiography in children with wrist trauma. With this study we aim to evaluate the implementation of the Amsterdam Paediatric Wrist Rules in the Emergency Department.
Study objective
With implementation of the APWR we expect a reduction in the total amount of radiographs requested, without missing any clinical relevant fractures. We also expect a reduction in overall waiting times at the ED and a total amount of cost savings around 3 million euro's a year.
Study design
Outcomes will be evaluated at the end of the inclusion period.
Intervention
X-ray of the wrist or not.
Marjolein A.M. Mulders
Amsterdam
The Netherlands
+31628243430
m.a.mulders@amc.nl
Marjolein A.M. Mulders
Amsterdam
The Netherlands
+31628243430
m.a.mulders@amc.nl
Inclusion criteria
All patients from 3 till 18 years presenting with acute wrist trauma at the Emergency Department.
Exclusion criteria
- The injury occurred more than 72 hours previous to the presentation at the Emergency Department
- Patients who sustained multiple injuries with an Injury Severity Score (ISS) more than 16
- Patients whose X-rays were requested previous to their visit to the Emergency Department (for example by their general practitioner)
- A wrist fracture in the past 3 months
Design
Recruitment
IPD sharing statement
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| NTR-new | NL4860 |
| NTR-old | NTR5105 |
| Other | 14.17.0327 : W13_101 |