Utility of Ottawa Ankle Rules in an Aging Population: Evidence for Addition of an Age Criterion
Section snippets
Methods
This is a multicenter, retrospective analysis of patients presenting to 1 of 9 urban EDs in the mid-Atlantic region from 2012 to 2017. Patients included in this analysis presented to the ED with a chief complaint of ankle pain for <7 days secondary to a low-energy trauma. International Classification of Diseases, Revision 9 (ICD-9) and ICD-10 codes were used to retrospectively identify individuals who met these requirements. ICD-9 codes included 824.0 to 824.7 to capture all distal
Results
We included 491 adult patients (317 female and 174 male) in this analysis, with an average (± standard deviation) age of 54.4 ± 21.6 years (range 18 to 96). Of these patients, 80.0% met OAR, with 67.9% displaying fractures. The OAR displayed a sensitivity of 98.2% and a specificity of 58.6% in the entire cohort.
Discussion
OAR is a validated screening tool for identifying ankle fractures in patients presenting with ankle injuries (8). Current reported sensitivities for these rules range from 96% to 100%, whereas the specificity remains much lower and varies, with a range of 7.8% to 45.8% (10, 11, 12, 13,17). When calculated based on this study's entire patient population, OAR displayed a sensitivity and specificity of 98.2% and 58.6%, respectively. The higher-than-average specificity seen in this study could be
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Conflict of Interest: None reported.