Paediatric Emergency Care; Applied Research Network Prediction Rule for Early Detection of Intra-Abdominal Injuries in Children

Abstract

Background: Blunt abdominal trauma is the third most common cause of pediatric trauma deaths, but it is the most common  unrecognized fatal injury.

Objective: Our study aimed to assess the Pediatric Emergency Care Applied Research Network (PECARN) score rule regarding early  prediction of intra-abdominal injuries in children with blunt abdominal trauma in order to improve their outcome and reduce percentage  of missed abdominal injuries.

Methods: A cross-sectional observational study included 123 children presented to Emergency Department  in Suez Canal University Hospital, Ismailia with blunt abdominal trauma within 24 hours. All the patients included in the  study were subjected to full history, data of trauma, clinical examination and routine laboratory and radiological investigations.

Results: The mean age of our study participants was 9.49 ± 4.379 years. The majority of participants (65.0%) were males. Regarding CT with IV  contrast, it was found to be abnormal in 62 children (50.4%). PECARN is statistically significantly positively correlated with organ injury (V=  0.532) (p ˂ 0.001). PECARN clinical prediction showed significant area under curve of 0.945 with maximum sensitivity of 80.6% and  specificity of 98.1% with accuracy of 88.7%.

Conclusion: Pediatric emergency care applied research network prediction score (PECARN)  had a valuable role in prediction of intra-abdominal injuries in children with blunt abdominal trauma (BAT).