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Performance of individual criteria of the Pediatric Emergency Care Applied Research Network (PECARN) intraabdominal injury prediction rule

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Title: Performance of individual criteria of the Pediatric Emergency Care Applied Research Network (PECARN) intraabdominal injury prediction rule
Authors: Cosby G. Arnold, Paul Ishimine, Kevan A. McCarten‐Gibbs, Kenneth Yen, Nisa Atigapramoj, Mohamed Badawy, Irma T. Ugalde, Pradip P. Chaudhari, Jeffrey S. Upperman, Nathan Kuppermann, James F. Holmes
Source: Academic Emergency Medicine. 32:643-649
Publisher Information: Wiley, 2025.
Publication Year: 2025
Description: ObjectiveThe Pediatric Emergency Care Applied Research Network (PECARN) derived and externally validated a clinical prediction rule to identify children with blunt torso trauma at low risk for intraabdominal injuries undergoing acute intervention (IAIAI). Little is known about the risk for IAIAI when only one or two prediction rule variables are positive. We sought to determine the risk for IAIAI when either one or two PECARN intraabdominal injury rule variables are positive.MethodsWe performed a planned secondary analysis of a prospective, multicenter study that included 7542 children (AI (IAI undergoing therapeutic laparotomy, angiographic embolization, blood transfusion, or two or more nights of intravenous fluids).ResultsAmong the 7542 children enrolled, 2986 (39.6%, 95% confidence interval [CI] 38.5%–40.7%) had one or two PECARN variables positive and were included. Of this subpopulation, 227 (7.6%, 95% CI 6.7%–8.6%) had intraabdominal injuries. In the 1639 patients with only one rule variable positive, 21 (1.3%, 95% CI 0.8%–2.0%) had IAIAI. In the 1347 patients with two rule variables positive, 27 (2.0%, 95% CI 1.3%–2.9%) had IAIAI. Risk for IAIAI for each variable was highest for Glasgow Coma Scale (GCS) score AI when two variables were present was highest when decreased breath sounds (three of 44, 6.8%, 95% CI 1.4%–18.7%) and GCS ConclusionsFew children with blunt torso trauma and one or two PECARN predictor variables present have IAIAI. Those with GCS score AI.
Document Type: Article
Language: English
ISSN: 1553-2712
1069-6563
DOI: 10.1111/acem.15084
Rights: Wiley Online Library User Agreement
Accession Number: edsair.doi...........cecce4eaa1b3944e1d13ee5ad045f2a9
Database: OpenAIRE
Description
Abstract:ObjectiveThe Pediatric Emergency Care Applied Research Network (PECARN) derived and externally validated a clinical prediction rule to identify children with blunt torso trauma at low risk for intraabdominal injuries undergoing acute intervention (IAIAI). Little is known about the risk for IAIAI when only one or two prediction rule variables are positive. We sought to determine the risk for IAIAI when either one or two PECARN intraabdominal injury rule variables are positive.MethodsWe performed a planned secondary analysis of a prospective, multicenter study that included 7542 children (AI (IAI undergoing therapeutic laparotomy, angiographic embolization, blood transfusion, or two or more nights of intravenous fluids).ResultsAmong the 7542 children enrolled, 2986 (39.6%, 95% confidence interval [CI] 38.5%–40.7%) had one or two PECARN variables positive and were included. Of this subpopulation, 227 (7.6%, 95% CI 6.7%–8.6%) had intraabdominal injuries. In the 1639 patients with only one rule variable positive, 21 (1.3%, 95% CI 0.8%–2.0%) had IAIAI. In the 1347 patients with two rule variables positive, 27 (2.0%, 95% CI 1.3%–2.9%) had IAIAI. Risk for IAIAI for each variable was highest for Glasgow Coma Scale (GCS) score AI when two variables were present was highest when decreased breath sounds (three of 44, 6.8%, 95% CI 1.4%–18.7%) and GCS ConclusionsFew children with blunt torso trauma and one or two PECARN predictor variables present have IAIAI. Those with GCS score AI.
ISSN:15532712
10696563
DOI:10.1111/acem.15084