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ACCURACY OF PECARN DECISION RULE IN MINOR BLUNT HEAD TRAUMA IN PEDIATRIC EMERGENCY DEPARTMENT: A META-ANALYSIS
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  • Ke Yang,
  • Meng Zhao,
  • Jing Sun,
  • Xiuli Nie
Ke Yang
The First People's Hospital of Tianmen City
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Meng Zhao
First Affiliated Hospital of Nanjing Medical University
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Jing Sun
Shengli Oilfield Central Hospital
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Xiuli Nie
Jinan Central Hospital Affiliated to Shandong University
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Abstract

Background: Pediatric Emergency Care Applied Research Network (PECARN) is a useful Clinical Decision Support Tool (CDST) to identify traumatic brain injuries and reduce the use of head CT scans among pediatric patients. The present Meta-analysis aims to evaluate the diagnostic accuracy of the PECARN rule from 2009 to 2020 in children with a very low risk of blunt head trauma. Methods: A detailed search was conducted from the databases of Medline (via PubMed), Cinahl (via Ebsco), Scopus, Web of Sciences, from 2009 till the end of December 2020 using the keywords like decrease use of CT scan, blunt head trauma (BHT) combined with accuracy, Pediatric Emergency Care Applied Research Network (PECARN) OR Clinical Decision Support Tool (CDST). Studies showing the diagnostic accuracy of the PECARN rule in children younger than 18 years of age with minor BHT were included. Results: 13 studies were included in the present analysis. Pooled sensitivity of 0.08, (95% confidence interval of 0.074 - 0.087), pooled specificity of 0.20 ( 95% CI of 0.196 - 0.213) and diagnostic odds ratio of 0.004 (95% CI of 0.000-0.1666) was in <2 years of age. The overall sensitivity of 0.07, specificity of 0.66, and diagnostic odds ratio of 0.54 (95% CI of 0.10 -2.78) was seen in ≥2 years of age. Overall sensitivity of 0.13 (95% CI 0.12-0.14), specificity of 0.81 (95% CI 0.80-0.82) and diagnostic odds ratio of 0.79 (95% CI of 0.08 -7.71) was in 0-18 years of age. Conclusion: The present analysis indicates the PECARN decision tool as an accurate CDST in low-risk minor blunt head trauma cases in children below two years of age and can become a useful tool in reducing Head CT’s scan overuse in pediatric emergency departments.

Peer review status:ACCEPTED

10 May 2021Submitted to International Journal of Clinical Practice
12 May 2021Submission Checks Completed
12 May 2021Assigned to Editor
22 May 2021Reviewer(s) Assigned
07 Jun 2021Review(s) Completed, Editorial Evaluation Pending
09 Jun 2021Editorial Decision: Revise Major
15 Jun 20211st Revision Received
16 Jun 2021Submission Checks Completed
16 Jun 2021Assigned to Editor
16 Jun 2021Review(s) Completed, Editorial Evaluation Pending
21 Jun 2021Editorial Decision: Accept