PECARN rules for Non-contrast Brain CT scan in children under 2 years of age with minor head trauma
DOI:
https://doi.org/10.52547/uiemj.1.1.28Keywords:
Traumatic brain injury, Pediatric, Emergency medicine, X-ray Computed TomographyAbstract
Objective: The present study aims to investigate compliance with Pediatric Emergency Care Applied Research Network (PECARN) rules in the decisions for brain Computed tomography (CT) examination in children aged below two years old with minor head trauma.
Methods: In this retrospective study, 234 medical records of children with mild Traumatic brain injury (TBI) who had undergone brain CT scan in the emergency department of Namazi hospital in Shiraz, from March 2017 to February 2019 were assessed for meeting PECARN guidelines for CT scan indication. Data were analyzed for sensitivity and specificity.
Result: Among 234 patients who received CT examination, 187 (79.9%) patients met the PECARN rules criteria, and 47 (21.1%) patients did not meet PECARN rules. PECARN had a sensitivity and specificity of 93.05 and 41.11%, respectively, in predicting positive brain CT findings in children under two years. But, in our study, there were 10 cases of false-negative PECARN.
Conclusion: In this study, which was conducted by including all the predictor values of the PECARN guidelines, the rate of compliance with PECARN rules was 79.9 % which can be improved by using a computerized decision support system based on PECARN rules and help clinicians to reduce the rates of unnecessary CT scans. But there was a low specificity of 41.11% which might be due to retrospective evaluation of the medical records, warranting the need for further retrospective studies.
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