Application of PECARN rules would significantly decrease CT rates in a Dutch cohort of children with minor traumatic head injuries

Nicky Niele, Marlies van Houten, Ellen Tromp, J. B. van Goudoever, Frans B. Plötz*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

The aim of this study was to determine the potential impact of the Pediatric Emergency Care Applied Research Network (PECARN) rules on the CT rate in a large paediatric minor traumatic head injury (MTHI) cohort and compare this with current national Dutch guidelines. This was a planned sub-study of a prospective multicentre observational study that enrolled 1006 children younger than 18 years with MTHI. We calculated the number of recommended CT scans and described trauma-related CT scan abnormalities. The PECARN rules recommended a significantly lower percentage of CT scans in all age categories, namely 101/357 (28.3%) versus 164/357 (45.9%) (p < 0.001) in patients under 2 years of age and 148/623 (23.8%) versus 394/623 (63.2%) (p < 0,001) versus in patients 2 years and older. Conclusion: The projected CT rate can significantly be reduced if the PECARN rules are applied. We therefore advocate that the PECARN guidelines are also implemented in The Netherlands.What is Known:• To guide clinicians whether to perform a CT scan in children with a minor traumatic head injury (MTHI) clinical decision rules has been developed.• The overall CT scan rate in adherence with the Dutch MTHI guidelines is 44%.What is New:• The projected CT rate can significantly be reduced in a Dutch cohort of MTHI if the PECARN rules are applied.• The Dutch national guidelines for MTHI can safely be replaced by the PECARN rules.

Original languageEnglish
Pages (from-to)1597-1602
Number of pages6
JournalEuropean Journal of Pediatrics
Volume179
Issue number10
DOIs
Publication statusPublished - 1 Oct 2020

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