External validation of a pediatric decision rule for blunt abdominal trauma.

Autor: Sigal AP; Department of Emergency Medicine Reading Hospital West Reading Pennsylvania USA., Deaner T; Department of Emergency Medicine Reading Hospital West Reading Pennsylvania USA., Woods S; Department of Emergency Medicine Reading Hospital West Reading Pennsylvania USA., Mannarelli E; Department of Emergency Medicine Reading Hospital West Reading Pennsylvania USA., Muller AL; Department of Surgery Section of Trauma and Critical Care Reading Hospital West Reading Pennsylvania USA., Martin A; Department of Surgery Section of Trauma and Critical Care Reading Hospital West Reading Pennsylvania USA., Schoener A; Penn State Berks Reading Pennsylvania USA., Brower M; Syracuse University Syracuse New York USA., Ong A; Department of Surgery Section of Trauma and Critical Care Reading Hospital West Reading Pennsylvania USA., Geng T; Department of Surgery Section of Trauma and Critical Care Reading Hospital West Reading Pennsylvania USA., Guillen F; Drexel University College of Medicine Philadelphia Pennsylvania USA., Lahmann B; Department of Emergency Medicine Reading Hospital West Reading Pennsylvania USA., Wasser T; Department of Emergency Medicine Reading Hospital West Reading Pennsylvania USA., Valente C; Department of Emergency Medicine Reading Hospital West Reading Pennsylvania USA.
Jazyk: angličtina
Zdroj: Journal of the American College of Emergency Physicians open [J Am Coll Emerg Physicians Open] 2022 Jan 15; Vol. 3 (1), pp. e12623. Date of Electronic Publication: 2022 Jan 15 (Print Publication: 2022).
DOI: 10.1002/emp2.12623
Abstrakt: Introduction: Blunt traumatic injuries are a leading cause of morbidity and mortality in the pediatric population. Contrast-enhanced multidetector computed tomography is the best imaging tool for screening patients at risk of blunt abdominal injury. The Pediatric Emergency Care Applied Research Network (PECARN) abdominal rule was derived to identify patients at low risk for significant abdominal injury who do not require imaging.
Methods: We conducted a retrospective review of pediatric patients with blunt trauma to validate the PECARN rule in a non-pediatric specialized hospital from February 3, 2013, through December 31, 2019. We excluded those with penetrating or mild isolated head injury. The PECARN decision rule was retrospectively applied for the presence of a therapeutic intervention, defined as a laparotomy, angiographic embolization, blood transfusion, or administration of intravenous fluids for pancreatic or gastrointestinal injury. Sensitivity and specificity analysis were conducted along with the negative and positive predictive values.
Results: A total of 794 patients were included in the final analysis; 23 patients met the primary outcome for an acute intervention. The PECARN clinical decision rule (CDR) had a sensitivity of 91.3%, a negative predictive value of 99.5, and a negative likelihood ration of 0.16.
Conclusion: In a non-pediatric specialty hospital, the PECARN blunt abdominal CDR performed with comparable sensitivity and negative predictive value to the derivation and external validation study performed at specialized children's hospitals.
Competing Interests: The authors declare no conflict of interest.
(© 2022 The Authors. JACEP Open published by Wiley Periodicals LLC on behalf of American College of Emergency Physicians.)
Databáze: MEDLINE
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