Use the Ottawa SAH Rule to rule out subarachnoid hemorrhage
Among patients presenting to the emergency department with acute nontraumatic headache that reached maximal intensity within 1 hour and who had normal neurologic examination findings, the Ottawa SAH Rule was highly sensitive for identifying subarachnoid hemorrhage.
In patients meeting the inclusion criteria, SAH was ruled out in the absence of:
In the population studied the Ottawa SAH rule had 100% (95% CI, 97.2%-100.0%) sensitivity and 15.3% (95% CI, 13.8%-16.9%) specificity.
The authors note that the study results apply only to patients with the specific inclusion/exclusion criteria described and require additional evaluation in implementation studies before the rule is applied in routine clinical care.
Perry JJ et al.
Inclusion criteria:
Age ≥ 15
New, severe nontraumatic headache
Maximum intensity within 1 hour
Exclusion criteria
New neurologic deficit
Previous aneurysm
Known brain tumor
History of recurrent headaches
Among patients presenting to the emergency department with acute nontraumatic headache that reached maximal intensity within 1 hour and who had normal neurologic examination findings, the Ottawa SAH Rule was highly sensitive for identifying subarachnoid hemorrhage.
In patients meeting the inclusion criteria, SAH was ruled out in the absence of:
In the population studied the Ottawa SAH rule had 100% (95% CI, 97.2%-100.0%) sensitivity and 15.3% (95% CI, 13.8%-16.9%) specificity.
The authors note that the study results apply only to patients with the specific inclusion/exclusion criteria described and require additional evaluation in implementation studies before the rule is applied in routine clinical care.
Perry JJ et al.
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