Open AccessValidation of Pediatric Emergency Care Applied Research Network (PECARN) rule in children with minor head trauma
Author(s) -
Sooje Cho,
Soyun Hwang,
Jae Yun Jung,
Young Ho Kwak,
Do Kyun Kim,
Jin Hee Lee,
Jin Hee Jung,
Joong Wan Park,
Hyuksool Kwon,
Dongbum Suh
Publication year - 2022
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0262102
Subject(s) - medicine , observational study , head injury , retrospective cohort study , head trauma , emergency department , emergency medicine , computed tomography , pediatric trauma , cohort study , pediatrics , poison control , injury prevention , surgery , psychiatry
The Pediatric Emergency Care Applied Research Network (PECARN) rule is commonly used for predicting the need for computed tomography (CT) scans in children with mild head trauma. The objective of this study was to validate the PECARN rule in Korean children presenting to the pediatric emergency department (PED) with head trauma. This study was a multicenter, retrospective, observational cohort study in two teaching PEDs in Korea between August 2015 and August 2016. In this observational study, 448 patients who visited PEDs were included in the final analysis. Risk stratification was performed with clinical decision support software based on the PECARN rule, and decisions to perform CT scans were subsequently made. Patients were followed-up by phone call between 7 days and 90 days after discharge from the PED. The sensitivity and specificity were analyzed. The sensitivity was 100% for all age groups, and no cases of clinically important traumatic brain injury (ciTBI) were identified in the very-low-risk group. CT scans were performed for 14.7% of patients in this study and for 33.8% in the original PECARN study. The PECARN rule successfully identified low-risk patients, and no cases of ciTBI were missed despite the reduced proportion of patients undergoing CT scans.