The Pediatric Emergency Care Applied Research Network intermediate-risk predictors were not associated with scanning decisions for minor head injuries

Aim: This study determined the predictors associated with the decision to perform a computed tomography (CT) scan in children with a minor head injury (MHI). We focused on those facing an intermediate risk of clinically important traumatic brain injury (ciTBI), according to the Pediatric Emergency Care Applied Research Network (PECARN) prediction rule. Methods: A 1-year, cross-sectional study was performed in an Italian paediatric emergency department, focusing on children presenting within 24 h of an MHI and meeting the PECARN intermediate-risk criteria. Results: We included 308 children, and 47% were younger than 2 years of age. CT scans were carried out on 13%, 1.3% had a ciTBI and one was initially missed but did not need neurosurgery following diagnosis. Single and multiple PECARN intermediate-risk predictors were not associated with whether a CT scan was carried out. The only clinical variable associated with the decision to perform a CT scan was if the child was <3 months of age (OR 18.1, 95% CI, 4.91-66.61). Conclusion: The PECARN intermediate-risk predictors did not play a major role in the decision to perform a CT scan. The only factor significantly associated with the decision to perform a CT scan was when the patient was younger than 3 months of age.