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01.02.2019 | Original Article

Impact of the Pediatric Emergency Care Applied Research Network (PECARN) guidelines on emergency department use of head computed tomography at a level I safety-net trauma center

verfasst von: Noam Gerber, Kelley Sookraj, Swapna Munnangi, L. D. George Angus, Vineet Lamba, Krishan Kumar, Brinda Doraiswamy

Erschienen in: Emergency Radiology | Ausgabe 1/2019

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Abstract

Purpose

To evaluate whether the emergency department usage of head computed tomography (CT) on pediatric patients with minor head trauma changed after publication of the Pediatric Emergency Care Applied Research Network (PECARN) head CT guidelines and to identify risk factors associated with performing head CT on patients without a PECARN guideline indication.

Methods

This retrospective study included 484 patients 18 years of age or younger who presented to the emergency department with head injury and a total Glasgow Coma Scale score ≥ 14 between September 2005 and July 2014. Based on the guideline publication date of September 2009, the study cohort was stratified into pre-guideline and post-guideline groups. Head CT performance, indications, and findings were compared between study periods. Logistic regression was used to identify risk factors associated with performing a non-indicated head CT.

Results

The rate of head CTs performed did not significantly change in the post-guideline period (96.6% vs. 95.7%, p = 0.63). There was no significant difference in the proportion of head CTs performed in patients with indications for head CT (100.0% vs. 100.0%) nor in patients without an indication for head CT (85.7% vs. 82.6%, p = 0.65) between the study periods. Females were significantly more likely to have a non-indicated head CT (OR: 2.73, 95% CI: 1.67–4.45) performed.

Conclusions

Head CT ordering practices for pediatric patients with head injury did not change at a level I trauma center after publication of the PECARN head CT guidelines.

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Titel: Impact of the Pediatric Emergency Care Applied Research Network (PECARN) guidelines on emergency department use of head computed tomography at a level I safety-net trauma center
verfasst von: Noam Gerber
Kelley Sookraj
Swapna Munnangi
L. D. George Angus
Vineet Lamba
Krishan Kumar
Brinda Doraiswamy
Publikationsdatum: 01.02.2019
Verlag: Springer International Publishing
Erschienen in: Emergency Radiology / Ausgabe 1/2019
Print ISSN: 1070-3004
Elektronische ISSN: 1438-1435
DOI: https://doi.org/10.1007/s10140-018-1645-4

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Impact of the Pediatric Emergency Care Applied Research Network (PECARN) guidelines on emergency department use of head computed tomography at a level I safety-net trauma center