Concussion Prediction Rules Can Decrease Need For CT Scans For Children: Study

The implentation of special concussion rules in the emergency room reduces the need for children to undergo CT scans, according to the findings of new research. 

In a study published in the March 2017 issue of the medical journal Pediatrics, researchers indicate that using traumatic brain injury prediction rules led to a small, but significant, decrease in the need for children to have CT scans.

The research involved the use of the Pediatric Emergency Care Applied Research Network (PECARN) traumatic brain injury rules in five pediatric emergency rooms and eight general emergency rooms. More than 16,000 patients and 2,300 control patients were evaluated.

Patients under 18 with minor blunt head trauma were evaluated between November 2011 and June 2014.

Researchers in the new study said CT scan rates “decreased significantly but modestly” at two of four pediatric ERs for children at very low risk. Rates decreased between 2.3 to 3.7 percent.

Among the other two pediatric ERs, CT scan rates had smaller decreases of between 0.8 and 1.5 percent. CT scan rates did not decrease at intervention ERs. Those rates remained steady at 2.1 to 4 percent among children at very low risk.

Among control ERs, CT scan rates in similar children decreased slightly, with decreases of 1.6 percent to 2.9 percent. However, control ERs also indicated a decrease in CT rates from 7.1 to 2.6 percent.

Researchers said for all children who experience concussions, mild or traumatic, decreases in CT scan rates ranged from 1.7 to 6.2 percent.

Reducing CT scans is important in reducing the amount of radiation to which children are exposed. Early and accurate diagnosis of a head injury is sometimes vital in avoiding long-term injury, or a return to activities that could increase the risk of another concussion.

Traumatic brain injury rates among young athletes have skyrocketed in recent decades, resulting in more than 2 million teens who remain untreated for head injuries. Head injury diagnosis is often crucial in deciding if and when the youth should take part in that particular sport or activity in the near future, or if they should wait.

Other studies have linked brain trauma to increased risk of dementia later in life, increased rates of depression, and increased risk of Alzheimer’s, even after only a single head trauma event. People who suffered a concussion are also twice as likely to die from unintentional injury.

Overall, implementing TBI prediction rules and recommendations was associated with “modest, safe, but variable decreases in CT use.” Researchers say this is key to reducing the strain TBI has placed on ERs, as recent studies have suggested ER visits due to concussions have increase 30 percent in recent years.