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Emergency Radiology

, Volume 26, Issue 1, pp 45–52 | Cite as

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

  • Noam GerberEmail author
  • Kelley Sookraj
  • Swapna Munnangi
  • L. D. George Angus
  • Vineet Lamba
  • Krishan Kumar
  • Brinda Doraiswamy
Original Article

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.

Keywords

Computed tomography Head injury PECARN Children Trauma Emergency medicine 

Notes

Compliance with ethical standards

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© American Society of Emergency Radiology 2018

Authors and Affiliations

  1. 1.Department of SurgeryNassau University Medical CenterEast MeadowUSA
  2. 2.Department of PediatricsNassau University Medical CenterEast MeadowUSA

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