Factors predictive for computed tomography use and abnormality in paediatric head injuries in Australia and New Zealand

Catherine L Wilson¹, Stephen Jc Hearps², Emma J Tavender^{1

3}, Natalie T Phillips^{4

5}, Ben Lawton^{4

6

7

8}, Frances Kinnear⁹, Amie Beattie^{10

11}, Hugh Mitenko^{12

13}, Russell Young¹⁴, Joanne Cole¹⁵, Amit Kochar¹⁶, Shane George^{17

18

19}, Stephen Ss Teo^{20

21}, Thomas Georgeson²², Adam Michael^{23

24}, Ashes Mukherjee^{25

26}, Alex King^{24

27}, Lalith Gamage^{28

29}, Peter Archer^{30

31}, Corey Cassidy³², Arjun Rao^{33

34}, Deepali Thosar³⁵, Meredith L Borland^{36

37}, Franz E Babl^{1

3

31}

Affiliations

¹ Emergency Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
² Brain and Mind, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
³ Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.
⁴ Emergency Department, Queensland Children's Hospital, Brisbane, Queensland, Australia.
⁵ Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia.
⁶ Emergency Department, Logan Hospital, Logan, Queensland, Australia.
⁷ School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
⁸ Don't Forget the Bubbles, Brisbane, Queensland, Australia.
⁹ Adult and Children's Emergency Department, The Prince Charles Hospital, Chermside, Queensland, Australia.
¹⁰ Emergency Department, Tamworth Hospital, Tamworth, New South Wales, Australia.
¹¹ Westpac Rescue Helicopter Service, Tamworth, New South Wales, Australia.
¹² Emergency Department, Bunbury Hospital, Bunbury, Western Australia, Australia.
¹³ Emergency Medicine Research, The University of Western Australia Medical School, Bunbury, Western Australia, Australia.
¹⁴ Emergency Department, Albany Hospital, Albany, Western Australia, Australia.
¹⁵ Emergency Department, Tauranga Hospital, Tauranga, New Zealand.
¹⁶ Paediatric Emergency Department, Women's and Children's Hospital, Adelaide, South Australia, Australia.
¹⁷ Department of Emergency Medicine and Children's Critical Care, Gold Coast University Hospital, Gold Coast, Queensland, Australia.
¹⁸ Paediatric Critical Care Research Group, Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia.
¹⁹ School of Medicine and Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia.
²⁰ Emergency and Paediatric Departments, Blacktown and Mt Druitt Hospitals, Sydney, New South Wales, Australia.
²¹ Paediatrics and Child Health, School of Medicine, Western Sydney University, Sydney, New South Wales, Australia.
²² Emergency Department, Canberra Hospital, Canberra, Australian Capital Territory, Australia.
²³ Emergency Department, Bundaberg Hospital, Bundaberg, Queensland, Australia.
²⁴ School of Medicine, Rural Clinical School, The University of Queensland, Brisbane, Queensland, Australia.
²⁵ Emergency Department, Armadale Kelmscott District Memorial Hospital, Perth, Western Australia, Australia.
²⁶ Emergency Medicine, The University of Western Australia, Perth, Western Australia, Australia.
²⁷ Emergency Department, Toowoomba Hospital, South Toowoomba, Queensland, Australia.
²⁸ Paediatric Department, Port Augusta Hospital and Regional Health Services, Port Augusta, South Australia, Australia.
²⁹ Emergency Department, Women's and Children's Hospital, Adelaide, South Australia, Australia.
³⁰ Emergency Department, Eastern Health, Melbourne, Victoria, Australia.
³¹ Emergency Department, Royal Children's Hospital, Melbourne, Victoria, Australia.
³² Department of Emergency Medicine, Ipswich Hospital, Ipswich, Queensland, Australia.
³³ Emergency Department, Sydney Children's Hospital, Sydney, New South Wales, Australia.
³⁴ Department of Medicine, School of Women's and Children's Health, The University of New South Wales, Sydney, New South Wales, Australia.
³⁵ Emergency Department, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
³⁶ Emergency Department, Perth Children's Hospital, Perth, Western Australia, Australia.
³⁷ Divisions of Paediatrics and Emergency Medicine, School of Medicine, The University of Western Australia, Perth, Western Australia, Australia.

PMID: 33354919
DOI: 10.1111/1742-6723.13694

Factors predictive for computed tomography use and abnormality in paediatric head injuries in Australia and New Zealand

Catherine L Wilson et al. Emerg Med Australas. 2021 Feb.

. 2021 Feb;33(1):157-160.

doi: 10.1111/1742-6723.13694. Epub 2020 Dec 22.

Authors

Affiliations

¹ Emergency Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
² Brain and Mind, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
³ Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.
⁴ Emergency Department, Queensland Children's Hospital, Brisbane, Queensland, Australia.
⁵ Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia.
⁶ Emergency Department, Logan Hospital, Logan, Queensland, Australia.
⁷ School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
⁸ Don't Forget the Bubbles, Brisbane, Queensland, Australia.
⁹ Adult and Children's Emergency Department, The Prince Charles Hospital, Chermside, Queensland, Australia.
¹⁰ Emergency Department, Tamworth Hospital, Tamworth, New South Wales, Australia.
¹¹ Westpac Rescue Helicopter Service, Tamworth, New South Wales, Australia.
¹² Emergency Department, Bunbury Hospital, Bunbury, Western Australia, Australia.
¹³ Emergency Medicine Research, The University of Western Australia Medical School, Bunbury, Western Australia, Australia.
¹⁴ Emergency Department, Albany Hospital, Albany, Western Australia, Australia.
¹⁵ Emergency Department, Tauranga Hospital, Tauranga, New Zealand.
¹⁶ Paediatric Emergency Department, Women's and Children's Hospital, Adelaide, South Australia, Australia.
¹⁷ Department of Emergency Medicine and Children's Critical Care, Gold Coast University Hospital, Gold Coast, Queensland, Australia.
¹⁸ Paediatric Critical Care Research Group, Child Health Research Centre, The University of Queensland, Brisbane, Queensland, Australia.
¹⁹ School of Medicine and Menzies Health Institute Queensland, Griffith University, Southport, Queensland, Australia.
²⁰ Emergency and Paediatric Departments, Blacktown and Mt Druitt Hospitals, Sydney, New South Wales, Australia.
²¹ Paediatrics and Child Health, School of Medicine, Western Sydney University, Sydney, New South Wales, Australia.
²² Emergency Department, Canberra Hospital, Canberra, Australian Capital Territory, Australia.
²³ Emergency Department, Bundaberg Hospital, Bundaberg, Queensland, Australia.
²⁴ School of Medicine, Rural Clinical School, The University of Queensland, Brisbane, Queensland, Australia.
²⁵ Emergency Department, Armadale Kelmscott District Memorial Hospital, Perth, Western Australia, Australia.
²⁶ Emergency Medicine, The University of Western Australia, Perth, Western Australia, Australia.
²⁷ Emergency Department, Toowoomba Hospital, South Toowoomba, Queensland, Australia.
²⁸ Paediatric Department, Port Augusta Hospital and Regional Health Services, Port Augusta, South Australia, Australia.
²⁹ Emergency Department, Women's and Children's Hospital, Adelaide, South Australia, Australia.
³⁰ Emergency Department, Eastern Health, Melbourne, Victoria, Australia.
³¹ Emergency Department, Royal Children's Hospital, Melbourne, Victoria, Australia.
³² Department of Emergency Medicine, Ipswich Hospital, Ipswich, Queensland, Australia.
³³ Emergency Department, Sydney Children's Hospital, Sydney, New South Wales, Australia.
³⁴ Department of Medicine, School of Women's and Children's Health, The University of New South Wales, Sydney, New South Wales, Australia.
³⁵ Emergency Department, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.
³⁶ Emergency Department, Perth Children's Hospital, Perth, Western Australia, Australia.
³⁷ Divisions of Paediatrics and Emergency Medicine, School of Medicine, The University of Western Australia, Perth, Western Australia, Australia.

PMID: 33354919
DOI: 10.1111/1742-6723.13694

Abstract

Objectives: To investigate patient-level factors predictive for computed tomography of the brain (CTB) use and abnormality in head injured children in Australia and New Zealand.

Methods: Retrospective data from tertiary, urban/suburban and regional/rural EDs including factors predictive for CTB use and abnormality.

Results: Of 3072 children at 31 EDs, 212 (6.9%) had a CTB scan, of which 66 (31%) were abnormal. Increasing age, serious mechanisms of injury and decreasing Glasgow Coma Score were predictive for ordering CTB. Decreasing age was predictive for CTB abnormalities. Other factors were not.

Conclusion: Patient-level drivers of CTB use in children in Australia and New Zealand are consistent with international data.

Keywords: brain injury; computed tomography; emergency medicine; head injury; paediatric.

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References

1. Babl FE, Borland ML, Phillips N et al. Accuracy of PECARN, CATCH, and CHALICE head injury decision rules in children: a prospective cohort study. Lancet 2017; 389: 2393-402.
1. Marin JR, Weaver MD, Barnato AE, Yabes JG, Yealy DM, Roberts MS. Variation in emergency department head computed tomography use for pediatric head trauma. Acad. Emerg. Med. 2014; 21: 987-95.
1. Klassen TP, Reed MH, Stiell IG et al. Variation in utilization of computed tomography scanning for the investigation of minor head trauma in children: a Canadian experience. Acad. Emerg. Med. 2000; 7: 739-44.
1. Stanley RM, Hoyle JD Jr, Dayan PS et al. Emergency department practice variation in computed tomography use for children with minor blunt head trauma. J. Pediatr. 2014; 165: 1201-6.
1. Wilson CL, Tavender EJ, Phillips NT et al. Variation in CT use for paediatric head injuries across different types of emergency departments in Australia and New Zealand. Emerg. Med. J. 2020; 37: 686-9.

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Factors predictive for computed tomography use and abnormality in paediatric head injuries in Australia and New Zealand

Affiliations

Factors predictive for computed tomography use and abnormality in paediatric head injuries in Australia and New Zealand

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

LinkOut - more resources

Full Text Sources

Medical