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Validation of the Canadian Assessment of Tomography for Childhood Head Injury, the CATCH-rule
Örebro University, School of Medical Sciences. Örebro University Hospital. Anaesthesia and Intensive Care, Section for Neurosurgery.
Örebro University Hospital. Örebro University, School of Medical Sciences. Anaesthesia and Intensive Care, Section for Neurosurgery.
2018 (English)In: Journal of Neurotrauma, ISSN 0897-7151, E-ISSN 1557-9042, Vol. 35, no 16, p. A248-A248Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: Head trauma in children is a common cause for a visit to the A&E. Among the many children it is important to identify those at risk for developing a clinical important head injury (CITBI). The most important way of identifying the children at risk is to perform a CT scan of the head. There are reports indicating an induction of 1 cancer in children on 1000 – 5000 CT examinations. It is thus important to minimise the use of CT. In 2010 Osmond and co-workers introduced the Canadian Assessment of Tomography for Childhood Head injury: the CATCH rule (CATCH-R), with the aim of identifying those at most risk and to reduce the use of CT. The aim of this study is to validate the CATCH-R, using a large cohort of children.

Material Methods: The study is a cohort study based on the data set from: ‘‘Identification of children at very low risk of clinically-important brain injuries after head trauma: a prospective cohort study’’(Kuppermanns et al 2009). It includes data from more than 43000 children. The cohort was identified using the basal criteria in the CATCH-R, i.e. children with a GCS of 13 – 15. The CATCH-R was then used to identify children who should perform a CT.

Results: We identified 37277 children with a GCS of 13 – 15 of which 7774 fulfilled the criteria for MHI according to the CATCH-R. Of these 2699 had one or more risk factors, i.e. should perform a CT scan. In the CT group 117 children had a CITBI and in the non-CT group (n=5075) we identified 36 children with CITBI. At the division MHI and no-MHI according to the CATCH-R the NPV is 99.2 % (CI 99.1 – 99.2 %), and specificity 79.3% (CI 78.9 – 79.7). At the division MHI with risk factor/s and MHI without risk factor/s the NPV is 99.3% (CI 99.1 – 99.5 %), and specificity 66.1 % (CI 65.0 – 67.2 %).

Conclusion: It seems that using the CATCH-R the risk of not detecting a child with a CITBI is very small.

Place, publisher, year, edition, pages
Mary Ann Liebert, 2018. Vol. 35, no 16, p. A248-A248
Keywords [en]
Pediatric, Concussion / mTBI
National Category
Neurology
Identifiers
URN: urn:nbn:se:oru:diva-68772ISI: 000441527400664OAI: oai:DiVA.org:oru-68772DiVA, id: diva2:1246004
Conference
3rd Joint Symposium of the International-and-National-Neurotrauma-Societies-and-AANS/CNS-Section on Neurotrauma and Critical Care, AUG 11-16, 2018, Toronto, CANADA
Available from: 2018-09-06 Created: 2018-09-06 Last updated: 2018-10-04Bibliographically approved

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Olivecrona, MagnusOlivecrona, Zandra

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