NEXUS 胸部决策工具（钝性伤）
用途适用： blunt trauma patients (typically >14 y) when chest radiograph/CT is being considered.
分层Any positive criterion supports imaging; all negative may allow omission.
局限不适用： penetrating chest trauma or clear mediastinal injury pathway. · 易错点： missing distracting injury or subtle chest-wall tenderness. · Does not replace aortic imaging triggers when clinically indicated.
出处Rodriguez RM, et al. JAMA Surg 2013 (NEXUS Chest)
本班次下一步
评完分数后：进场景连算、看相邻评分、打开对应路径。本地参考，不写入 HIS。
方法学 · 公式代入、指南要点与完整说明
适用场景
适用： blunt trauma patients (typically >14 y) when chest radiograph/CT is being considered.
需要填写的项目
- Age > 60 years · 选项
- Rapid deceleration (fall >20 ft / 6 m or MVC >40 mph / 64 km/h) · 选项
- Chest pain · 选项
- Intoxication · 选项
- Abnormal alertness / mental status · 选项
- Distracting painful injury · 选项
- Tenderness to chest-wall palpation · 选项
计算方法与公式
Low-risk iff ALL absent: age>60, rapid deceleration, chest pain, intoxication, abnormal alertness, distracting injury, chest-wall tenderness.
Assess mechanism thresholds carefully (fall >20 ft / MVC >40 mph).
公式代入演示
下列数值取自本工具各输入项的示例值，用本页公式在服务端实际算出，供快速核对计算过程。仅演示代入方法，不构成临床建议，也不代表任何真实病例。
| Age > 60 years | 否 |
|---|---|
| Rapid deceleration (fall >20 ft / 6 m or MVC >40 mph / 64 km/h) | 否 |
| Chest pain | 否 |
| Intoxication | 否 |
| Abnormal alertness / mental status | 否 |
| Distracting painful injury | 否 |
| Tenderness to chest-wall palpation | 否 |
→NEXUS ChestLow-risk — imaging may be deferred
- Positive criteria：None
- Population：Typically blunt trauma age >14 in derivation/validation
| Age > 60 years | 是 |
|---|---|
| Rapid deceleration (fall >20 ft / 6 m or MVC >40 mph / 64 km/h) | 是 |
| Chest pain | 是 |
| Intoxication | 是 |
| Abnormal alertness / mental status | 是 |
| Distracting painful injury | 是 |
| Tenderness to chest-wall palpation | 是 |
→NEXUS ChestNot low-risk — image
- Positive criteria：7
- Population：Typically blunt trauma age >14 in derivation/validation
结果判读与分层
Any positive criterion supports imaging; all negative may allow omission.
指南要点（原创整理）
- Seven criteria, all-or-none low risk.
- Validated for selective imaging.
- 下一步： trauma primary survey; NEXUS Chest CT instrument if CT-specific pathway used.
以上为依据相应指南的关键推荐、由本站用自己的语言归纳整理（非指南原文）；完整内容请见下方官方来源。
注意事项与局限
- 不适用： penetrating chest trauma or clear mediastinal injury pathway.
- 易错点： missing distracting injury or subtle chest-wall tenderness.
- Does not replace aortic imaging triggers when clinically indicated.
核对与出处 · 可验证治理
参考指南与出处
- Rodriguez RM, et al. JAMA Surg 2013 (NEXUS Chest) · 来源 ↗
指南全文版权归相应学会/期刊所有；本工具仅实现其决策算法并注明出处，全文请经上方官方来源获取。
依据文献年份见参考 · 数据集整理日 2026-10-08
常见问题
常见问题
- NEXUS 胸部决策工具（钝性伤）的计算是否上传患者数据？在哪里计算？
- 计算在浏览器本地完成，输入与结果不上传服务器；结果仅供执业医师参考，须结合病史、检查与本机构方案判断，不构成诊断或处方依据。
- NEXUS 胸部决策工具（钝性伤）怎么代入计算？能举个例子吗？
- 代入: Age > 60 years 否、Rapid deceleration (fall >20 ft / 6 m or MVC >40 mph / 64 km/h) 否、Chest pain 否、Intoxication 否、Abnormal alertness / mental status 否、Distracting painful injury 否、Tenderness to chest-wall palpation 否 → 结果: NEXUS Chest Low-risk — imaging may be deferred（Positive criteria: None、Population: Typically blunt trauma age >14 in derivation/validation） 代入: Age > 60 years 是、Rapid deceleration (fall >20 ft / 6 m or MVC >40 mph / 64 km/h) 是、Chest pain 是、Intoxication 是、Abnormal alertness / mental status 是、Distracting painful injury 是、Tenderness to chest-wall palpation 是 → 结果: NEXUS Chest Not low-risk — image（Positive criteria: 7、Population: Typically blunt trauma age >14 in derivation/validation）
核对流程与方法学
核对与依据
本工具的公式与计算方法已在本页明示、公开可逐一核查。其公式、系数与阈值依据上方「参考指南与出处」列出的权威来源核对。想了解本站对全部临床工具的核对流程与出处覆盖情况，见 临床工具核对表与方法学 →