Predictors of abnormal computed tomography findings for paediatric head injury: a retrospective cohort study

Objectives: Head injuries in children are common causes for visits to the emergency department (ED). Computed tomography (CT) scans are useful for confirming head injury diagnoses. However, radiation exposure from CT scans might cause lethal malignancies. We aimed to examine predictors for the indication of performing CT scans necessary for diagnosis.

Design: Retrospective cohort study.

Setting: Three EDs in Japan

Participants: Patients aged <16 years with head trauma who underwent CT.

Primary and Secondary Outcome Measures: The primary outcome measure was abnormal CT findings that were evaluated using the area under the receiver-operating characteristic curve (AUC). We derived predictors from three existing CDRs: Canadian Assessment of Tomography for Childhood Head Injury (CATCH), Children’s Head Injury Algorithm for the Prediction of Important Clinical Events (CHALICE), and Paediatric Emergency Care Applied Research Network (PECARN).

Results: Of 1,103 eligible patien...

研究目的：儿童颅脑损伤是急诊科（ED，emergency department）就诊的常见病因。计算机断层扫描（CT，Computed Tomography）是确诊颅脑损伤的有效手段，但CT扫描带来的辐射暴露可能引发致死性恶性肿瘤。本研究旨在探究影响诊断所需CT扫描指征的预测因素。
研究设计：回顾性队列研究。
研究地点：日本3家急诊科。
研究对象：年龄<16岁、因颅脑创伤接受CT检查的患者。
主要与次要结局指标：主要结局指标为采用受试者工作特征曲线下面积（AUC，area under the receiver-operating characteristic curve）评估的异常CT表现。本研究从3项现有临床决策规则（CDR，Clinical Decision Rules）中提取预测因素，分别为：儿童颅脑损伤CT评估量表（CATCH，Canadian Assessment of Tomography for Childhood Head Injury）、儿童颅脑损伤重要临床事件预测算法（CHALICE，Children’s Head Injury Algorithm for the Prediction of Important Clinical Events）以及儿科急诊护理应用研究网络量表（PECARN，Paediatric Emergency Care Applied Research Network）。
结果：共纳入1103名合格患者……