Assessment of a Handheld Near-Infrared Spectroscopy Device in Detecting Traumatic Intracranial Hemorrhage in Uganda

Abstract

AbstractBackground: Traumatic brain injury (TBI) is a leading cause of morbidity and mortality worldwide, particularly in low- and middle-income countries (LMICs) like Uganda, where the burden is disproportionately high due to factors such as the prevalence of motorcycle accidents and the limited neurosurgical resources. Computed tomography (CT) scans are essential to TBI care, though a limited resource in LMICs. This study aims to assess the diagnostic accuracy of the handheld near infrared device (NIRD), Infrascanner 2500™, in identifying traumatic intracranial hemorrhage in Uganda. The study will evaluate the device's sensitivity, specificity, and predictive values against CT scans in neurotrauma patients. Methods: Patients with suspected head trauma at Mbarara Regional Referral Hospital (MRRH) and Mayanja Memorial Hospital (MMH) who received a head CT scan were included. Participants were scanned with the Infrascanner 2500™ within 30 minutes after their head CT scan. Participant demographics, presenting characteristics, and Infrascanner 2500™ output were recorded. Results: Of the 137 participants included in this interim analysis, 62 (45%) were positive for intracranial hematoma. The Infrascanner 2500™ showed a sensitivity of 83.9% and a specificity of 25.3%. The positive predictive value and negative predictive value were 48.1% and 65.5% respectively. Results showed a high false positive rate across the cohort. Conclusion: This study demonstrated the Infrascanner 2500TM with low specificity and sufficient specificity for detecting intracranial bleeds for patients with TBI in Uganda. The refinement of NIR devices and continued investigation into factors affecting the Infrascanner 2500TM diagnostic performance will be essential to its potential for improving TBI management.