Rules for intra-abdominal injury and traumatic brain injury rules applied in pediatric emergency departments
By Lori Solomon HealthDay Reporter
FRIDAY, April 26, 2024 (HealthDay News) — The Pediatric Emergency Care Applied Research Network (PECARN) intra-abdominal injury and traumatic brain injury rules show a high degree of accuracy in pediatric emergency departments, according to a study published in the May issue of The Lancet Child & Adolescent Health.
James F. Holmes, M.D., from University of California Davis in Sacramento, and colleagues validated the PECARN prediction rules for children presenting to emergency departments with blunt abdominal or minor head trauma. The analysis included 7,542 children with blunt abdominal trauma and 19,999 children with minor head trauma presenting to one of six emergency departments between Dec. 27, 2016, and Sept. 1, 2021.
The researchers found that the intra-abdominal injury rule had a sensitivity of 100.0 percent and a negative predictive value (NPV) of 100.0 percent for patients. The traumatic brain injury rule for children younger than 2 years had a sensitivity of 100.0 percent for clinically important traumatic brain injuries and an NPV of 100.0 percent. For children 2 years and older, the traumatic brain injury rule had a sensitivity of 98.8 percent and an NPV of 100.0 percent. Neither of the two children who were misclassified by the traumatic brain injury rule needed neurosurgery.
“Implementation [of the PECARN intra-abdominal injury and traumatic brain injury rules] in pediatric emergency departments can therefore be considered a safe strategy to minimize inappropriate CT use in children needing high-quality care for abdominal or head trauma,” the authors write.
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