The Predictive Impact of The PECARN Score in Pediatric Patients with Minor Head Trauma

Abstract

Aim: Head trauma is a leading cause of emergency department visits in children, with an annual incidence of 1.850 per 100.000. Computed tomography (CT) scans are the standard for diagnosing head trauma but involve risks like sedation, radiation exposure, and high costs. This raises the question of CT necessity for children with a Glasgow Coma Scale (GCS) score of 14 or above. The Pediatric Emergency Care Applied Research Network (PECARN) rules, introduced in 2009, aim to identify low-risk patients to reduce unnecessary CT scans and associated risks. Materials and Methods: This retrospective observational study reviewed patients under 18 with minor head trauma from January 1 to December 31, 2022. Inclusion criteria were a GCS score of 14 or higher and presentation within 24 hours of injury. Patients were evaluated using PECARN criteria and divided into two groups: Group A (age >2 years) and Group B (age <= 2 years). These groups were further categorized into low, medium, and high-risk levels. Clinically important traumatic brain injury was defined by criteria including death, surgery requirement, intubation, or hospitalization for two or more days. Data collected included patient age, gender, symptoms, and CT scan results. Statistical analyses were conducted using SPSS software. Results: The study found that 95.8% of low-risk patients under 2 years and all low-risk patients over 2 years had normal CT scans, supporting the PECARN criteria\"s effectiveness in identifying patients unlikely to benefit from CT imaging. Conclusion: Implementing PECARN guidelines can enhance patient safety, reduce radiation exposure, and optimize resource use in emergency settings.