Accuracy of PECARN head CT guidelines in predicting positive findings on CT of the head of patients after mild head injury in a large trauma center in Saudi Arabia

Lama Hassan Meriky; Ahmed Foad Basehi; Nadiyah Hussain Almohiy; Abdulaziz Asaad Alghamdi; Hani Hassan Altayim; Zainah Yahya Alshehri; Njoud Mousa Alenezy; Khaled Rashed Alenezi

doi:10.24911/IJMDC.51-1732130086

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Original Article
Online Published: 02 Jan 2025

IJMDC. 2024; 8(11): 3109-3115

doi: 10.24911/IJMDC.51-1732130086

Accuracy of PECARN head CT guidelines in predicting positive findings on CT of the head of patients after mild head injury in a large trauma center in Saudi Arabia

Lama Hassan Meriky, Ahmed Foad Basehi, Nadiyah Hussain Almohiy, Abdulaziz Asaad Alghamdi, Hani Hassan Altayim, Zainah Yahya Alshehri, Njoud Mousa Alenezy, Khaled Rashed Alenezi.

Abstract
Objective: This study aimed to evaluate the diagnostic performance of the pediatric emergency care applied research network (PECARN) head computed tomography (CT) rule in a pediatric emergency department in a large trauma center in Riyadh, Saudi Arabia.
Methodology: This retrospective qualitative cross-sectional study reviewed the records of pediatric patients with minor head injuries (MHIs) who presented to the emergency department at King Abdullah Specialized Children’s Hospital. Patients who underwent head CT scans were included, with minor head injury defined by a Glasgow coma scale score of 14-15. The study population was divided into two age groups: below 2 years and 2 years and above. The PECARN criteria were retrospectively applied to determine the justification for head CTs. Data on demographic, clinical, and radiological profiles were collected.
Results: A total of 1,132 pediatric patients were included, with 372 under 2 years of age and 760 aged 2 years and above. Overall, 38.8% of the patients had positive CT findings, while 60.2% had negative findings. According to the PECARN criteria, 4.9% of the cases met the criteria for head CT. The PECARN rule demonstrated a sensitivity of 9.2%, a specificity of 97.9%, a positive predictive value (PPV) of 74.5%, and a negative predictive value of 62.2%.
Conclusion: The PECARN head CT rule showed high specificity and PPV, supporting its effectiveness in identifying pediatric patients with MHIs who do not require CT scans, thus minimizing unnecessary radiation exposure. However, the significant proportion of unjustified CTs highlighted the need for better adherence to the PECARN criteria in clinical practice. Enhancing physician education and improving clinical documentation might optimize the use of the PECARN rule and improve patient care in pediatric emergency settings.

Key words: Accuracy, PECARN, head CT, guidelines, Saudi Arabia

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Pubmed Style

Meriky LH, Basehi AF, Almohiy NH, Alghamdi AA, Altayim HH, Alshehri ZY, Alenezy NM, Alenezi KR. Accuracy of PECARN head CT guidelines in predicting positive findings on CT of the head of patients after mild head injury in a large trauma center in Saudi Arabia. IJMDC. 2024; 8(11): 3109-3115. doi:10.24911/IJMDC.51-1732130086

Web Style

Meriky LH, Basehi AF, Almohiy NH, Alghamdi AA, Altayim HH, Alshehri ZY, Alenezy NM, Alenezi KR. Accuracy of PECARN head CT guidelines in predicting positive findings on CT of the head of patients after mild head injury in a large trauma center in Saudi Arabia. https://www.ijmdc.com/?mno=229617 [Access: January 14, 2025]. doi:10.24911/IJMDC.51-1732130086

AMA (American Medical Association) Style

Meriky LH, Basehi AF, Almohiy NH, Alghamdi AA, Altayim HH, Alshehri ZY, Alenezy NM, Alenezi KR. Accuracy of PECARN head CT guidelines in predicting positive findings on CT of the head of patients after mild head injury in a large trauma center in Saudi Arabia. IJMDC. 2024; 8(11): 3109-3115. doi:10.24911/IJMDC.51-1732130086

Vancouver/ICMJE Style

Meriky LH, Basehi AF, Almohiy NH, Alghamdi AA, Altayim HH, Alshehri ZY, Alenezy NM, Alenezi KR. Accuracy of PECARN head CT guidelines in predicting positive findings on CT of the head of patients after mild head injury in a large trauma center in Saudi Arabia. IJMDC. (2024), [cited January 14, 2025]; 8(11): 3109-3115. doi:10.24911/IJMDC.51-1732130086

Harvard Style

Meriky, L. H., Basehi, . A. F., Almohiy, . N. H., Alghamdi, . A. A., Altayim, . H. H., Alshehri, . Z. Y., Alenezy, . N. M. & Alenezi, . K. R. (2024) Accuracy of PECARN head CT guidelines in predicting positive findings on CT of the head of patients after mild head injury in a large trauma center in Saudi Arabia. IJMDC, 8 (11), 3109-3115. doi:10.24911/IJMDC.51-1732130086

Turabian Style

Meriky, Lama Hassan, Ahmed Foad Basehi, Nadiyah Hussain Almohiy, Abdulaziz Asaad Alghamdi, Hani Hassan Altayim, Zainah Yahya Alshehri, Njoud Mousa Alenezy, and Khaled Rashed Alenezi. 2024. Accuracy of PECARN head CT guidelines in predicting positive findings on CT of the head of patients after mild head injury in a large trauma center in Saudi Arabia. International Journal of Medicine in Developing Countries, 8 (11), 3109-3115. doi:10.24911/IJMDC.51-1732130086

Chicago Style

Meriky, Lama Hassan, Ahmed Foad Basehi, Nadiyah Hussain Almohiy, Abdulaziz Asaad Alghamdi, Hani Hassan Altayim, Zainah Yahya Alshehri, Njoud Mousa Alenezy, and Khaled Rashed Alenezi. "Accuracy of PECARN head CT guidelines in predicting positive findings on CT of the head of patients after mild head injury in a large trauma center in Saudi Arabia." International Journal of Medicine in Developing Countries 8 (2024), 3109-3115. doi:10.24911/IJMDC.51-1732130086

MLA (The Modern Language Association) Style

Meriky, Lama Hassan, Ahmed Foad Basehi, Nadiyah Hussain Almohiy, Abdulaziz Asaad Alghamdi, Hani Hassan Altayim, Zainah Yahya Alshehri, Njoud Mousa Alenezy, and Khaled Rashed Alenezi. "Accuracy of PECARN head CT guidelines in predicting positive findings on CT of the head of patients after mild head injury in a large trauma center in Saudi Arabia." International Journal of Medicine in Developing Countries 8.11 (2024), 3109-3115. Print. doi:10.24911/IJMDC.51-1732130086

APA (American Psychological Association) Style

Meriky, L. H., Basehi, . A. F., Almohiy, . N. H., Alghamdi, . A. A., Altayim, . H. H., Alshehri, . Z. Y., Alenezy, . N. M. & Alenezi, . K. R. (2024) Accuracy of PECARN head CT guidelines in predicting positive findings on CT of the head of patients after mild head injury in a large trauma center in Saudi Arabia. International Journal of Medicine in Developing Countries, 8 (11), 3109-3115. doi:10.24911/IJMDC.51-1732130086

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