RT Journal Article
T1 Variability in the management of infants under 3 months with minor head injury in paediatric emergency departments
A1 Alonso-Cadenas, Jose Antonio
A1 Calderon Checa, Rosa Maria
A1 Garcia-Loygorri, Clara Ferrero
A1 Hidalgo, Isabel Duran
A1 Perez Garcia, Maria Jose
A1 Gomez, Pablo Delgado
A1 Garcia, Raquel Jimenez
A1 Grp Trabajo Traumatismo, 
K1 Paediatric emergency department
K1 Minor head injury
K1 Infants
K1 Children younger
K1 Trauma
AB Introduction: In the assessment of infants younger than 3 months with minor traumatic head injury (MHI), it is essential to adapt the indication of imaging tests. The Pediatric Head Injury/Trauma Algorithm (PECARN) clinical prediction rule is the most widely used to guide clinical decision making.Objectives: To analyse the variability in the performance of imaging tests in infants under 3 months with MHI in paediatric emergency departments and the adherence of each hospital to the recommendations of the PECARN rule. Population and methods: We conducted a prospective multicentre observational study in 13 paediatric emergency departments in Spain between May 2017 and November 2020.Results: Of 21,981 children with MHI, 366 (1.7%) were aged less than 3 months; 195 (53.3%) underwent neuroimaging, with performance of CT scans in 37 (10.1%; interhospital range, 0%-40.0%), skull X-rays in 162 (44.3%; range, 0%-100%) and transfontanellar ultrasound scans in 22 (6.0%; range, 0%-24.0%). The established recommendations were followed in 25.6% (10/39) of infants classified as high-risk based on PECARN criteria (range, 0%-100%); 37.1% (36/97) clas-sified as intermediate-risk (range, 0%-100%) and 57.4% (132/230) classified as low-risk (range, 0%-100%).Conclusion: We found substantial variability and low adherence to the PECARN recommenda-tions in the performance of imaging tests in infants aged less than 3 months with MHI in Spanish paediatric emergency departments s, mainly due to an excessive use of skull X-rays.(c) 2022 Asociacion Espanola de Pediatria. Published by Elsevier Espana, S.L.U. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/ 4.0/).
PB Ediciones doyma s a
SN 1695-4033
YR 2023
FD 2023-02-01
LK http://hdl.handle.net/10668/21969
UL http://hdl.handle.net/10668/21969
LA en
DS RISalud
RD Apr 19, 2025