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Prediction Rules for Brain Injury Can Cut Down on Scans

Last Updated: September 15, 2009.

Children at very low risk for brain injury following head trauma can be identified using a set of prediction rules that obviate the need for a computed tomography scan, according to a study published online Sept. 15 in The Lancet.

TUESDAY, Sept. 15 (HealthDay News) -- Children at very low risk for brain injury following head trauma can be identified using a set of prediction rules that obviate the need for a computed tomography (CT) scan, according to a study published online Sept. 15 in The Lancet.

Nathan Kuppermann, M.D., of the University of California in Davis, and colleagues conducted a study of 42,412 children enrolled from 25 emergency departments in North America, who presented with Glasgow Coma Scales scores of 14 to 15 within 24 hours of head trauma. The CT scans for 14,969 (35.3 percent) of the children were obtained.

Within the cohort, 376 children sustained clinically important traumatic brain injuries and 60 underwent neurosurgery, the researchers found. When the scientists applied six prediction rules for the patients under 2 years of age, such as how they behaved after the injury, how it was sustained and mental status, they were able to accurately predict the likelihood of clinically significant brain injury 100 percent of the time, and applying similar rules to children two years of age and over had 99.95 percent accuracy.

"Application of these rules could limit CT use, protecting children from unnecessary radiation risks," the authors write. "Furthermore, these rules provide the necessary data to assist clinicians and families in CT decision making after trauma."

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