The prevalence of abnormal brain CT scans in pediatrics emergency department: two years single-center retrospective chart review study

Abstract

Background: Traumatic head injury represents a substantial cause of trauma in pediatric emergency rooms (ER). This study aimed to calculate the prevalence of abnormal CT scan reports (CT) in the pediatric ER at King Abdullah Specialized Children's Hospital (KASCH) in Riyadh. In addition, it examined different variables that are more likely associated with a normal CT scan. Methods: This single-center retrospective chart review study was conducted using non-probability convenience sampling; data were collected from the electronic health records of ER pediatric patients. Patients aged 0 to 14 years, who had a trauma and a brain CT scan ordered in KASCH ER, from May 2017 to May 2019 were included. Results: In total, 502 CT scans were done due to a traumatic head-related event. About a third (34.5%, n=173) had an abnormal CT scan, with the majority of the group (69.4%, n=120) being male. The highest rate of abnormal CT scans (28.9%) was in the 2 to 5 years age group. The most common mechanism of injury was falling (55%), followed by motor vehicle accidents (MVA) (33.5%). Falling, as a mechanism of injury, were accounted for more than half of the injuries in both the normal (57.1%) and abnormal (50.9%) CT scans. Conclusion: Two thirds of the head CT included in this study resulted in normal CT findings and a considerable number of the abnormal findings were linear non-displaced fractures that can be detected by X-ray.