Multicentre study found no increased risk of clinically important brain injuries when children presented more than 24 h after a minor head trauma.

Autor: Vajna de Pava M; Paediatric Emergency Department, ASST dei Sette Laghi, Varese, Italy., Milani GP; Paediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.; Department of Clinical Science and Community Health, University of Milan, Milan, Italy., Zuccotti GV; Department of Paediatrics, Ospedale dei Bambini Vittore Buzzi, Milan, Italy.; Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy., Tommasi P; Department of Paediatrics, Ospedale dei Bambini Vittore Buzzi, Milan, Italy., Calvi M; Paediatric Emergency Department, ASST Papa Giovanni XXIII, Bergamo, Italy., Amoroso A; Paediatric Emergency Department, ASST Papa Giovanni XXIII, Bergamo, Italy., Montesano P; Department of Emergency Medicine, University Children's Hospital, Spedali Civili, Brescia, Italy., Boselli G; Department of Emergency Medicine, University Children's Hospital, Spedali Civili, Brescia, Italy., Castellazzi ML; Paediatric Emergency Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy., Agosti M; Woman and Child Department, ASST dei Sette Laghi, Varese, Italy.; Department of Medicine and Surgery, University of Insubria, Varese, Italy.
Jazyk: angličtina
Zdroj: Acta paediatrica (Oslo, Norway : 1992) [Acta Paediatr] 2022 Nov; Vol. 111 (11), pp. 2125-2130. Date of Electronic Publication: 2022 Aug 09.
DOI: 10.1111/apa.16507
Abstrakt: Aim: Validated clinical decision rules on neuroimaging are not available for children who are evaluated more than 24 h after a minor head trauma. We compared clinically important traumatic brain injuries in children who presented with a minor head trauma within or after 24 h.
Methods: This was a retrospective analysis of patients aged 0-17 years, who were evaluated for minor head traumas by five paediatric emergency departments in Northern Italy between January 2019 and June 2020. Children with clinically important traumatic brain injuries were divided into those who had presented within and after 24 h.
Results: The study comprised 5981 children (59.9% boys), with a median age of 2 years, including 243 (4.1%) who had presented more than 24 h after their minor head trauma. Neuroimaging was performed on 448 (7.5%) patients and the time of presentation had no impact on the rates of clinically important traumatic brain injuries. Multiple logistic regression did not show any association between clinically important traumatic brain injuries and late presentation.
Conclusion: Delayed presentation to a paediatric emergency department after a minor head trauma did not alter the risk of clinically important traumatic brain injuries and the same neuroimaging rules could apply.
(© 2022 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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