Paediatric Emergency Department, ASST dei Sette Laghi, Varese, Italy.
Paediatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Acta Paediatr. 2022 Nov;111(11):2125-2130. doi: 10.1111/apa.16507. Epub 2022 Aug 9.
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.
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.
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.
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.
对于在轻微头部外伤后 24 小时以上接受评估的儿童，尚无经过验证的神经影像学临床决策规则。我们比较了在轻微头部外伤后 24 小时内或之后就诊的儿童中具有临床意义的创伤性脑损伤。
这是一项回顾性分析，纳入了 2019 年 1 月至 2020 年 6 月期间意大利北部 5 个儿科急诊部评估的 0-17 岁儿童，这些儿童因轻微头部外伤就诊。将具有临床意义的创伤性脑损伤患儿分为在 24 小时内和之后就诊的患儿。
该研究共纳入 5981 例儿童（59.9%为男孩），中位年龄为 2 岁，其中 243 例（4.1%）在轻微头部外伤后 24 小时以上就诊。448 例（7.5%）患儿接受了神经影像学检查，就诊时间对具有临床意义的创伤性脑损伤发生率没有影响。多因素逻辑回归未显示具有临床意义的创伤性脑损伤与延迟就诊之间存在任何关联。
轻微头部外伤后到儿科急诊就诊时间延迟不会改变具有临床意义的创伤性脑损伤风险，可适用相同的神经影像学规则。
