Comparison of PECARN and CATCH clinical decision rules in children with minor blunt head trauma

• Published in: European journal of trauma and emergency surgery (Munich : 2007) 2019-10, Vol.45 (5), p.849-855
• Main Authors: Bozan, Ö., Aksel, G., Kahraman, H. A., Giritli, Ö., Eroğlu, S. E.
• Format: Article
• Language: English
• Subjects: Brain Concussion - diagnostic imaging; Brain Concussion - physiopathology; Child; Child, Preschool; Clinical decision making; Clinical Decision Rules; Craniocerebral Trauma - diagnostic imaging; Craniocerebral Trauma - physiopathology; Critical Care Medicine; Decision Support Techniques; Emergency medical care; Emergency Medicine; Emergency Service, Hospital; Female; Glasgow Coma Scale; Head injuries; Humans; Intensive; Male; Medicine; Medicine & Public Health; Original Article; Pathology; Pediatrics; Prospective Studies; Reproducibility of Results; Sports Medicine; Surgery; Surgical Orthopedics; Tomography; Tomography, X-Ray Computed; Trauma; Traumatic Surgery; Turkey; Wounds, Nonpenetrating - diagnostic imaging
• ISSN: 1863-9933; 1863-9941
• DOI: 10.1007/s00068-017-0865-8

Introduction and purpose Computerized brain tomography (CBT) imaging plays a key role in the management of patients with head trauma, and there is an indication for CBT in moderate and severe injuries. However, it is difficult to determine an indication for CBT in patients with minor head trauma. The primary aim of this study is to compare the efficiency of the most commonly used clinical decision rules: the guidelines of the Pediatric Emergency Care Applied Research Network (PECARN), and those of the Canadian Assessment of Tomography for Childhood Head Injury (CATCH). Methods The study, which was designed as a prospective cohort study, sought to determine the appropriate CBT indications for children younger than 18 years who were referred to the emergency department with minor blunt head trauma. The effectiveness of PECARN and CATCH clinical decision rules, which are recommended by literature to be applied in order to diagnose severely injured patients and minimize inappropriate CBT requests, was investigated. All patients included in this study were younger than 18 years of age, were admitted to the study with an isolated blunt head trauma, had a GCS of > 13, and had parental permission to participate in the study. Patients ages 18 and older, those with penetrating head trauma or trauma to other systems, those with GCS ≤ 13, those with incomplete data, and those whose parents did not agree to participate in the study, were excluded. Results A total of 256 patients were included in the study. PECARN and CATCH rules were both shown to be statistically significant in detecting the presence of pathology ( p