© 2017 Elsevier Ltd Background Clinical decision rules can help to determine the need for CT imaging in children with head injuries. We aimed to validate three clinical decision rules (PECARN, CATCH, and CHALICE) in a large sample of children. Methods In this prospective observational study, we included children and adolescents (age

Babl, Franz E.

Baylis, Amy

Borland, Meredith L.

Bressan, Silvia

Cheek, John A.

Crowe, Louise

Dalton, Sarah

Dalziel, Stuart

Dalziel, Stuart R.

Donath, Susan

Furyk, Jeremy

Gilhotra, Yuri

Jachno, Kim

Kochar, Amit

Lyttle, Mark D.

McCaskill, Mary

Molesworth, Charlotte

Neutze, Jocelyn

Oakley, Ed

Phillips, Natalie

Ward, Brenton

Williams, Amanda

English

Clinical decision rules can help to determine the need for CT imaging in children with head injuries. We aimed to validate three clinical decision rules (PECARN, CATCH, and CHALICE) in a large sample of children

Babl, Franz E

Borland, Meredith L

Mccaskill, Mary

Cheek, John A

Lyttle, Mark D

BRESSAN, SILVIA

Archivio istituzionale della ricerca - Università di Padova

Accuracy of PECARN, CATCH, and CHALICE head injury decision rules in children: a prospective cohort study

UWE Bristol Research Repository

Babl, FE

Borland, ML

Phillips, N

Kochar, A

Dalton, S

McCaskill, M

Cheek, JA

Gilhotra, Y

Neutze, J

Lyttle, MD

Bressan, S

Donath, S

Molesworth, C

Jachno, K

Ward, B

Williams, A

Baylis, A

Crowe, L

Oakley, E

Dalziel, SR

Deakin Research Online

Franz E Babl

Meredith L Borland

Natalie Phillips

Amit Kochar

Sarah Dalton

Mary McCaskill

John A Cheek

Yuri Gilhotra

Jeremy Furyk

Jocelyn Neutze

Mark D Lyttle

Silvia Bressan

Susan Donath

Charlotte Molesworth

Kim Jachno

Brenton Ward

Amanda Williams

Amy Baylis

Louise Crowe

Ed Oakley

Stuart R Dalziel

Crossref

The Lancet

Background Clinical decision rules can help to determine the need for CT imaging in children with head injuries. We aimed to validate three clinical decision rules (PECARN, CATCH, and CHALICE) in a large sample of children. Methods In this prospective observational study, we included children and adolescents (age

University of Queensland eSpace

Background: Clinical decision rules can help to determine the need for CT imaging in children with head injuries. We aimed to validate three clinical decision rules (PECARN, CATCH, and CHALICE) in a large sample of children. Methods: In this prospective observational study, we included children and adolescents (aged <18 years) with head injuries of any severity who presented to the emergency departments of ten Australian and New Zealand hospitals. We assessed the diagnostic accuracy of PECARN (stratified into children aged <2 years and ≥2 years), CATCH, and CHALICE in predicting each rule-specific outcome measure (clinically important traumatic brain injury [TBI], need for neurological intervention, and clinically significant intracranial injury, respectively). For each calculation we used rule-specific predictor variables in populations that satisfied inclusion and exclusion criteria for each rule (validation cohort). In a secondary analysis, we compiled a comparison cohort of patients with mild head injuries (Glasgow Coma Scale score 13–15) and calculated accuracy using rule-specific predictor variables for the standardised outcome of clinically important TBI. This study is registered with the Australian New Zealand Clinical Trials Registry, number ACTRN12614000463673. Findings: Between April 11, 2011, and Nov 30, 2014, we analysed 20 137 children and adolescents attending with head injuries. CTs were obtained for 2106 (10%) patients, 4544 (23%) were admitted, 83 (<1%) underwent neurosurgery, and 15 (<1%) died. PECARN was applicable for 4011 (75%) of 5374 patients younger than 2 years and 11 152 (76%) of 14 763 patients aged 2 years and older. CATCH was applicable for 4957 (25%) patients and CHALICE for 20 029 (99%). The highest point validation sensitivities were shown for PECARN in children younger than 2 years (100·0%, 95% CI 90·7–100·0; 38 patients identified of 38 with outcome [38/38]) and PECARN in children 2 years and older (99·0%, 94·4–100·0; 97/98), followed by CATCH (high-risk predictors only; 95·2%; 76·2–99·9; 20/21; medium-risk and high-risk predictors 88·7%; 82·2–93·4; 125/141) and CHALICE (92·3%, 89·2–94·7; 370/401). In the comparison cohort of 18 913 patients with mild injuries, sensitivities for clinically important TBI were similar. Negative predictive values in both analyses were higher than 99% for all rules. Interpretation: The sensitivities of three clinical decision rules for head injuries in children were high when used as designed. The findings are an important starting point for clinicians considering the introduction of one of the rules.Franz E Babl, Meredith L Borland, Natalie Phillips, Amit Kochar, Sarah Dalton, Mary McCaskill, John A Cheek, Yuri Gilhotra, Jeremy Furyk,
Jocelyn Neutze, Mark D Lyttle, Silvia Bressan, Susan Donath, Charlotte Molesworth, Kim Jachno, Brenton Ward, Amanda Williams, Amy Baylis,
Louise Crowe, Ed Oakley, Stuart R Dalziel, for the Paediatric Research in Emergency Departments International Collaborative (PREDICT

Accuracy of PECARN, CATCH, and CHALICE head injury decision rules in children: a prospective cohort study

Abstract

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Archivio istituzionale della ricerca - Università di Padova

UWE Bristol Research Repository

Deakin Research Online

Crossref

University of Queensland eSpace

Adelaide Research & Scholarship

Accuracy of PECARN, CATCH, and CHALICE head injury decision rules in children: a prospective cohort study

Abstract

Similar works

Full text

Available Versions

Archivio istituzionale della ricerca - Università di Padova

UWE Bristol Research Repository

Deakin Research Online

Crossref

University of Queensland eSpace

Adelaide Research &amp; Scholarship

Adelaide Research & Scholarship