TY  - JOUR
PY  - 2020//
TI  - Pediatric minor head trauma in Brazil and external validation of PECARN rules with a cost-effectiveness analysis
JO  - Brain injury
A1  - Furtado, Leopoldo Mandic Ferreira
A1  - da Costa Val Filho, José Aloysio
A1  - dos Santos, André Ribeiro
A1  - e sá, Raísa Furfuro
A1  - Sandes, Bruno Lacerda
A1  - Hon, Yangpol
A1  - dos Santos Júnior, Eustáquio Claret
A1  - Faleiro, Rodrigo Moreira
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - BACKGROUND: Pediatric minor head trauma approaches aim to ensure the absence of traumatic brain lesions, minimize ionizing radiation, and enhance cost control. We evaluated the applicability and cost-effectiveness of the Pediatric Emergency Care Applied Research Network (PECARN) rules after head trauma and rationalize the use of head computed tomography (CT) scans.     METHODS: We retrospectively divided patients <18 years old who presented at a single institution in Brazil with minor head trauma into four groups: Group I (skull X-ray only), Group II (head CT only), Group III (X-ray and CT), and Group IV (observation only). Direct costs were calculated based on examination and length of hospitalization. The PECARN rules were applied retrospectively in each patient to determine who required a CT scan, and the costs were re-calculated.     RESULTS: Of the 1328 patients, CT scans were performed in 36.4% and X-rays in 52.6%. The mean cost was USD 5.88, 34.58, 41.85, and 4.04 for Groups I-IV, respectively. After applying the PECARN rules, 77.6% of patients no longer required a CT scan, and overall costs were reduced from USD 16.71 to 7.88 (p < .001). <br><br>CONCLUSION: The PECARN rules demonstrated a meaningful cost-effectiveness and should be applied to the Brazilian pediatric population.<p />  <p>Language: en</p>
LA  - en
SN  - 0269-9052
UR  - http://dx.doi.org/10.1080/02699052.2020.1802667
ID  - ref1
ER  -