Abstract:
OBJECTIVE:The Pediatric Emergency Care Applied Research Network (PECARN) traumatic brain injury (TBI) age-based clinical prediction rules identify children at very low risk of a significant head injury who can safely avoid CT. Our goal was to independently validate these prediction rules. DESIGN:Cross-sectional study. SETTING:Two paediatric emergency departments located in USA and in Italy. PATIENTS:All children presenting within 24 h of a head injury with a Glasgow Coma Score of ≥ 14. INTERVENTION:Assessment of PECARN TBI clinical predictors. MAIN OUTCOME MEASURE:Clinically important TBI defined as head injury resulting in death, intubation for >24 h, neurosurgery or two or more nights of hospitalisation for the management of head trauma. RESULTS:During the study period, we included 2439 children (91% of eligible patients), of which 959 (39%) were < 2 years of age and 1439 (59%) were male. Of the study patients, 373 (15%) had a CT performed, 69 (3%) had traumatic findings on their CT and 19 (0.8%) had a clinically important TBI. None of the children with a clinically important TBI were classified as very low risk by the PECARN TBI prediction rules (overall sensitivity 100%; 95% CI 83.2% to 100%, specificity 55%, 95% CI 52.5% to 56.6%, and negative predictive value 100%, 95% CI 99.6% to 100%). CONCLUSIONS:In our external validation, the age-based PECARN TBI prediction rules accurately identified children at very low risk for a clinically significant TBI and can be used to assist CT decision making for children with minor blunt head trauma.
journal_name
Postgrad Med Jjournal_title
Postgraduate medical journalauthors
Schonfeld D,Bressan S,Da Dalt L,Henien MN,Winnett JA,Nigrovic LEdoi
10.1136/postgradmedj-2013-305004repsubject
Has Abstractpub_date
2015-11-01 00:00:00pages
634-8issue
1081eissn
0032-5473issn
1469-0756pii
postgradmedj-2013-305004repjournal_volume
91pub_type
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