Lorton F, Levieux K, Vrignaud B, Hamel O, Jehlé E, Hamel A, Gras-Leguen C
Urgences pédiatriques, CHU de Nantes, 9, quai Moncousu, 44093 Nantes cedex 1, France.
Urgences pédiatriques, CHU de Nantes, 9, quai Moncousu, 44093 Nantes cedex 1, France.
Arch Pediatr. 2014 Jul;21(7):790-6. doi: 10.1016/j.arcped.2014.04.015. Epub 2014 Jun 13.
Minor head trauma is a common cause for pediatric emergency department visits. In 2009, the Pediatric Emergency Care Applied Research Network (PECARN) published a clinical prediction rule for identifying children at very low risk of clinically important traumatic brain injuries (ciTBI) and for reducing CT use because of malignancy induced by ionizing radiation. The prediction rule for ciTBI was derived and validated on 42,412 children in a prospective cohort study. The Société Française de Médecine d'Urgence (French Emergency Medicine Society) and the Groupe Francophone de Réanimation et Urgences Pédiatriques (French-Language Pediatric Emergency Care Group) recommend this algorithm for the management of children after minor head trauma. Based on clinical variables (history, symptoms, and physical examination findings), the algorithm assists in medical decision-making: CT scan, hospitalization for observation or discharge, according to three levels of ciTBI risk (high, intermediate, or low risk). The prediction rule sensitivity for children younger than 2 years is 100 % [86.3-100] and for those aged 2 years and older it is 96.8 % [89-99.6]. Our aim is to present these new recommendations for the management of children after minor head trauma.
轻度头部外伤是儿科急诊科就诊的常见原因。2009年，儿科急诊护理应用研究网络（PECARN）发布了一项临床预测规则，用于识别临床上重要的创伤性脑损伤（ciTBI）风险极低的儿童，并减少因电离辐射诱发恶性肿瘤而进行的CT检查。ciTBI的预测规则是在前瞻性队列研究中的42412名儿童中推导并验证的。法国急诊医学协会和法语区儿科急诊护理小组推荐该算法用于轻度头部外伤后儿童的管理。基于临床变量（病史、症状和体格检查结果），该算法有助于医疗决策：根据ciTBI风险的三个级别（高、中或低风险）进行CT扫描、住院观察或出院。2岁以下儿童的预测规则敏感性为100%[86.3 - 100]，2岁及以上儿童为96.8%[89 - 99.6]。我们的目的是介绍这些轻度头部外伤后儿童管理的新建议。
