订购计算机断层扫描的原因以及在儿科中级风险轻度头部创伤中发现的异常
Irene Ortiz-Santiago1, Nagore Ibarzabal-Segui1, Edurne López-Gutiérrez1,2
1Department of Pediatric Emergency, Biobizkaia Health Research Institute, Cruces University Hospital, Osakidetza, EHU, University of the Basque Country.
在中等风险轻度头部创伤的儿童中,影响CT扫描使用的因素与预测异常的因素不同. 吐,头痛和异常行为增加了CT扫描,而年轻年龄和严重伤害机制与异常有关.
科学领域:
- 儿科急救医学 儿科急救医学
- 放射学 放射学是一门学科.
- 创伤护理 创伤护理
背景情况:
- 轻度头部创伤在儿童中很常见.
- PECARN规则对风险进行分层,确定需要仔细评估的中等风险病例.
- CT扫描经常使用,但存在风险,需要谨慎应用.
研究的目的:
- 调查CT扫描在儿科中等风险轻度头部创伤中使用的决定因素.
- 为了确定与CT检测异常相关的因素在这个队列中.
- 要区分成像和发现的原因.
主要方法:
- 555名中等风险轻度头部创伤 (3个月14岁) 的儿童进行了回顾性观察研究.
- 从2021年到2022年的人口和临床数据的分析.
- 多变量逻辑回归用于识别与CT扫描使用和异常相关的因素.
主要成果:
- 在14.1%的患者中进行了CT扫描,在30.8%的被扫描患者中发现了异常.
- 临床上重要的创伤性脑损伤 (ciTBI) 在1.1%的患者中被发现.
- 与CT利用相关的因素包括吐,头痛,异常行为和医生评估的延迟.
- 年龄较小和严重伤害机制预测CT异常.
结论:
- 在中等风险儿科头部创伤中使用CT扫描是由临床症状和ED过程因素驱动的,而不仅仅是异常的可能性.
- 研究结果表明,在这一群体中,有可能改进CT决策标准.
- 需要进一步的研究来验证这些独特的预测因素.
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