PECARN's Clinical Prediction Rule for Pediatric Intra-abdominal Injuries Has 97% Sensitivity

Investigators in the Pediatric Emergency Care Applied Research Network (PECARN) network derived a clinical prediction rule to identify children (median age, 11 years) with acute blunt torso trauma at very low risk for having intra-abdominal injuries (IAIs) that require acute intervention.

The rule's seven variables identified 197 patients of the 203 (97%) with IAIs requiring intervention. The variables were as follows: (1) evidence of abdominal wall trauma or seat-belt sign; 2) Glasgow Coma Scale score <14; (3) abdominal tenderness; (4) evidence of thoracic wall trauma; (5) complaints of abdominal pain; (6) decreased breath sounds; and (7) vomiting. Of the 5034 patients (42%) deemed very low risk (no prediction variables present), 1254 (25%)…