Clinician Suspicion vs. the PECARN Rule for Pediatric Intra-Abdominal Injuries

The rule was more sensitive but less specific than clinical gestalt.

Children commonly undergo abdominal computed tomography (CT) after trauma, yet they rarely have intra-abdominal injury requiring acute intervention (such as laparotomy, embolization, blood transfusion, or prolonged intravenous fluids). The Pediatric Emergency Care Applied Research Network (PECARN) derived a clinical decision rule to identify children with very low risk for injury for whom CT was unlikely to be helpful (NEJM JW Emerg Med May 2013 and Ann Emerg Med 2013 Feb 4; [e-pub]). In a planned secondary analysis, researchers compared clinicians' estimates of the likelihood of injury requiring intervention (before knowing CT results) against the prediction rule (the rule had not been developed at the time of the primary study).

CT scans w…

Reviewing Author

Daniel M. Lindberg, MD

Disclosures

RoyaltiesUpToDate

Grant/Research SupportEunice Kennedy Shriver National Institute of Child Health and Human Development; MINDSOURCE

Editorial BoardsThe Quarterly Update: Reviews of Current Child Abuse Medical Research; Child Abuse & Neglect: The International Journal

Leadership Positions in Professional SocietiesThe Helfer Society (Executive Committee Member)