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

Bozan, Öner; Aksel, Gökhan; H, Kahraman; Giritli, Ö; Eroğlu, Serkan Emre

doi:10.1007/s00068-017-0865-8

Cited by 11 publications

(11 citation statements)

References 25 publications

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“…In a study in the literature, 94% of the patients were discharged from the pediatric emergency service. [3] In our study, 90% of the patients were monitored up to about 8 hours, and 97% of them weredischarged from thepediatricemergency service. We can explain one of the reasons for our high CT rate to be the shortness of our monitoring period.…”

Section: Discussionmentioning

confidence: 72%

“…It is also important to determine patients requiring CT because of the risk of cancer due to radiation. [3] Clinical decision rules help physicians for the decision ofthe requirement of a CT scan in patients with minor head trauma. Of these rules, the most frequently used is the USA based PECARN (The Pediatric Emergency Care Applied Research Network), while the England based CHALICE (The children's head injury algorithm for the prediction of important clinical eventsrule) and Canada based CATCH(Canadian Assessment of Tomography for Childhood Head injury rule) are other frequently used clinical decision rules.…”

Section: Introductionmentioning

confidence: 99%

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The Evaluation of Patients Admitted due to Minor Head Trauma with Clinical Decision Rules

Fidancı

Güleryüz

Çivit

2021

Journal of Contemporary Medicine

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We aimed to identify patients admitted to pediatric emergency service due to head trauma using clinical decisionmaking rules. Material and Method:This is a prospective cohort study involving who referred to a tertiary university hospital pediatric emergency service due to minor head trauma. Evaluations were made with PECARN, CATCH and CHALICE clinical decision rules.Results: 326 cases were included in the study. 63.5% (207) of the cases were male, and their ages were 52±52 months (min: 1 daymax: 214 months). 61.9% (202) of the cases were admitted due to a fall. 15.3% (49) cases presenting with minor head trauma had a (computed tomography) CT performed. In cases under the age of three months the CT scan rate was 66.6%, while it was 11% in cases over three months. 50% of the cases who had a CT scan satisfied the clinical decision rules. However, two cases who had traumatic brain injury(TBI) in the CT could not be determined with clinical decision rules. There was a statistically significant correlation between the presence of severe mechanism of injury and TBI findings in the CT(p<0,05). Conclusions:In the CT decision for patients who were admitted with minor head trauma, the role of clinical decision rules is note worthy. In addition, physician experience, the physicians' knowledge of clinical decision rules, the awareness of/raising awareness to the families about the harms of CT and the necessary conditions being provided by hospital observation units for the patients are also essential.

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Section: Discussionmentioning

confidence: 72%

Section: Introductionmentioning

confidence: 99%

The Evaluation of Patients Admitted due to Minor Head Trauma with Clinical Decision Rules

Fidancı

Güleryüz

Çivit

2021

Journal of Contemporary Medicine

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“…Besides, GCS is frequently used in separating the patients with head trauma into subgroups, diagnosis and treatment methods, and repetitive evaluation of patients. [15] It was reported in many previous studies that low GCS values and changes in consciousness are related to mortality due to brain damage and head trauma. [16][17][18] In addition, GCS and changes in consciousness are common physical examination findings that indicate a high risk in PECARN, CATCH, and CHALICE which are the most frequently used decision-making rules for MHTs in children.…”

Section: Discussionmentioning

confidence: 98%

Acil Servise Kafa Travmasi Nedeniyle Başvuran Çocuk Hastalarin Değerlendirilmesi

Ocak¹,

Akar

2021

Journal of Contemporary Medicine

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Aim: Head trauma is the most frequent reason for trauma related child deaths. Minor head traumas (MHT) form a considerable part of pediatric head traumas. Brain Computed Tomography (CT) is the gold standard for demonstrating intracranial pathologies in patients with head trauma. It is necessary to avoid having unnecessary CT scans in order to reduce the cost and the harms of radiation. We aim to assess the pediatric patients that applied to the emergency service with complaints of head trauma in the light of Prediction of Important Clinical Events (CHALICE) clinical decision-making rules. Material and Method: 200 patients under 18 years old who applied to the emergency service with complaints of head trauma between 2016 and 2019 are included in this retrospective study. Results: 200 patients in total were included in the study; of them, 128 are males and 72 are females. Of the patients, 3 have a Glaskow Coma Score (GCS) of 3-8, 2 have a GCS of 9-13, and the remaining 195 patients have a GCS of 14-15. Considering the symptoms, 35 patients had a headache, 28 patients had subcutaneous hematoma, and 26 patients had nausea-vomiting. The reason for trauma is motor vehicle accident for 99 patients and falling down from height for 95 patients. Four patients died. CHALICE (+) rate was found 67.82% in the patients having a brain CT scan. 41.95% of asymptomatic patients had a brain CT scan. Conclusion: Most of the patients participating in our study applied to the emergency service with minor head trauma. 32,18 percent of the patients who had brain CT were CHALICE (-) and 41.95% of the patients who had no symptoms showed us that unnecessary CT is performed at a high rate in pediatric MHT.

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“…According to the results of the same study, the positive predicted value was 19%, while the negative predicted value was 95%. 22 Lorton et al found among children under the age of 2 years that PECARN had a sensitivity of 100%, specificity of 64%, positive predicted value of 2%, and negative predicted value of 100%, while these values were, respectively, 100%, 72%, 2%, and 100% for children at the age of 2 years or older. For all cases, the sensitivity value was calculated as 100%, specificity was 70%, positive predicted value was 2%, and negative predicted value was 100%.…”

Section: Discussionmentioning

confidence: 98%

The comparison of PECARN, CATCH, AND CHALICE criteria in children under the age of 18 years with minor head trauma in emergency department

Gizli

Durak

Köksal

2022

Hong Kong j. emerg. med.

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Introduction: Minor head traumas constitute a significant part of childhood injuries. The incidence of intracranial pathologies in children with minor head trauma varies in the range of 3%–5%, but it is higher among younger infants. The criteria of the Pediatric Emergency Care Applied Research Network, Canadian Assessment of Tomography for Childhood Head Injury, and Children’s Head Injury Algorithm for the Prediction of Important Clinical Events are the most frequently accepted clinical decision-making criteria that were developed for selective computerized tomography requests. This study was conducted to assess the diagnostic performances of the Pediatric Emergency Care Applied Research Network, Canadian Assessment of Tomography for Childhood Head Injury, and Children’s Head Injury Algorithm for the Prediction of Important Clinical Events criteria in Turkish society, determine their validity, and find the most suitable algorithm for cranial imaging in children with minor head trauma. Methods: This study retrospectively examined the data of patients under the age of 18 years who were admitted to the Emergency Medicine Department of Uludağ University Medical Faculty due to minor head trauma; 530 patients were included as they complied with the criteria. The exclusion criteria were being any trauma patients above the age of 18 years, Glasgow Coma Scale <13, pregnant patients, hemorrhagic diathesis, using anticoagulants, patients with penetrant trauma, patients with priorly known brain tumor, and patients with neurological diseases. The patients were divided into group based on the Pediatric Emergency Care Applied Research Network, Canadian Assessment of Tomography for Childhood Head Injury, and Children’s Head Injury Algorithm for the Prediction of Important Clinical Events Criteria. Results: Among all patients, 37.40% were female and 62.60% were male. Abnormal computed tomography findings such as epidural bleeding, subdural bleeding, and skull fractures were detected in 44 of the patients. The sensitivity of the Pediatric Emergency Care Applied Research Network criteria was 72.4%, the specificity was 54.5%, the sensitivity of the Canadian Assessment of Tomography for Childhood Head Injury criteria was 57.8%, the specificity was 50%, the sensitivity of the Children’s Head Injury Algorithm for the Prediction of Important Clinical Events criteria was 87.7%, and the specificity was 20%. Conclusion: Given the populations to which the rules apply, it is understood that the Children’s Head Injury Algorithm for the Prediction of Important Clinical Events criteria is more determinative in detecting pathological computed tomography outcomes compared to Pediatric Emergency Care Applied Research Network and Canadian Assessment of Tomography for Childhood Head Injury.

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

Cited by 11 publications

References 25 publications

The Evaluation of Patients Admitted due to Minor Head Trauma with Clinical Decision Rules

The Evaluation of Patients Admitted due to Minor Head Trauma with Clinical Decision Rules

Acil Servise Kafa Travmasi Nedeniyle Başvuran Çocuk Hastalarin Değerlendirilmesi

The comparison of PECARN, CATCH, AND CHALICE criteria in children under the age of 18 years with minor head trauma in emergency department

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