Decision Rules for Children with Head Trauma Can Prevent Unnecessary CTs

A robust clinical decision rule for identifying children with head trauma who are at low risk for intracranial injury could eliminate unnecessary radiation exposure from computed tomography (CT) scans. In a multicenter North American study, researchers enrolled 42,412 children (age, ≤18 years) with mild head trauma (defined as Glasgow Coma Scale score >13) to derive and validate decision rules for two age groups: <2 years and ≥2 years.

The study outcome was complicated head trauma (defined as neurosurgery, death from traumatic brain injury, intubation for >24 hours, or hospital admission for ≥2 nights). The investigators defined rules (based on a derivation group of children) for avoiding CT in the two age groups (see table).

In the validatio…