Compliance with CATCH rules in administering computerized tomography scans to children admitted to the emergency department with minor head trauma
Yükleniyor...
Dosyalar
Tarih
2013
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Carbone Editore
Erişim Hakkı
info:eu-repo/semantics/closedAccess
Özet
Background: Traumatic brain injury (TBI) is a major health problem frequently encountered in children. Although TBI-associated acute brain damage is frequently observed in children, the need for neurosurgical intervention is rare. In many centers, it has become standard practice to assess children with minor TBI (Glasgow Coma Scale [GCS], 13-15) using head computerized tomography (CT). Therefore. preventing unnecessary CT imaging in children with minor TBI is important. The Canadian Assessment of Tomography for Childhood Head injury (CATCH) guidelines comprise precise rules aimed at reducing CT imaging in pediatric patients with minor TBI. In this study, we retrospectively investigated pediatric patients with head trauma who presented to our emergency clinic and assessed CATCH compliance in cases where CT scans were administered. Methods: This study was performed by retrospectively investigating children 0-18 years of age who had a record of head trauma and underwent brain CT imaging at the emergency clinic of a tertiary city hospital with an annual patient population of approximately 245.000. Children with minor TBI who met the CATCH criteria for CT imaging, including a decrease in GCS to <15 within 2 h following trauma, evidence of an open or depression fracture, irritability during examination, basal skull fracture. large or boggy hematoma on the scalp, fall from a height of 3 feet or down five steps, motorized vehicle accidents, and fall from a motorcycle without a hehnet. were included in this study. The findings regarding compliance with CATCH rules were analyzed statistically. Results: A total of 2.253 children with head trauma presenting over 1 year were examined, and 731 children (32.4%) who undenvent CT scans were included because they conformed to the CATCH rules. Approximately 20% (n = 148) of these cases were asymptomatic. Indications for CT imaging included a dangerous trauma mechanism (77.2%, n = 564), a linear fracture without acute brain damage (5.6%, n = 127), and acute brain damage (1.6%. n = 36). Four patients (0.2%) with depression fractures underwent surgery. Interpretation: It was difficult to reach a consensus on the decision for brain CT imaging for minor head trauma in the pediatric age group. The CATCH criterion related to falling from a height of >3 feet was the most frequent indication for CT imaging in our study. However, the trauma mechanism of simply falling from a height 3 feet was insufficient to justify a decision to perform a CT scan.
Açıklama
Anahtar Kelimeler
Head Trauma, Emergency Medicine, Traumatic Brain Injury, Computed Tomography
Kaynak
Acta Medica Mediterranea
WoS Q Değeri
Q4
Scopus Q Değeri
N/A
Cilt
29
Sayı
4
