Journal of Trauma and Injury

Original Articles

Evaluation of diagnostic performance of PECARN clinical decision rule in children with minor head trauma presenting to the emergency department of a tertiary care center: an observational study: Salooja Sulthana N, Nikhil Paul, Archu MJ, Keerthana Manoharan K K, Linu SM, Visakh S Vinod; J Trauma Inj. 2026;39(2):144-150. Published online April 22, 2026; DOI: https://doi.org/10.20408/jti.2025.0165

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Abstract PDF: Purpose
Minor head trauma is one of the most common reasons for pediatric emergency department visits. Accurate identification of children at risk for clinically important traumatic brain injury (ciTBI) is essential to reduce unnecessary computed tomography (CT) imaging. This study evaluated the diagnostic performance of the PECARN (Pediatric Emergency Care Applied Research Network) clinical decision rule in children with minor head trauma presenting to a tertiary care hospital in South India.
Methods
In this observational study conducted between September 2022 and April 2024, 235 children aged <18 years presenting with head trauma and Glasgow Coma Scale scores of 14–15 were prospectively enrolled. Participants were stratified into age-specific PECARN risk categories. Diagnostic performance was assessed against ciTBI outcomes defined by clinical and radiological criteria.
Results
The PECARN rule demonstrated strong diagnostic performance, with a sensitivity of 82.4%, specificity of 74.1%, and an area under the receiver operating characteristic curve of 0.90 (P=0.01). No cases requiring neurosurgical intervention were missed. Children aged ≥2 years had a higher incidence of ciTBI than those aged <2 years (13.4% vs. 1.8%, P=0.048). ciTBI was significantly associated with loss of consciousness, vomiting, severe headache, and signs of basilar skull fracture (all P<0.001).
Conclusions
The PECARN rule appears to be a reliable and safe tool for evaluating pediatric minor head trauma in Indian emergency settings. Its high sensitivity and negative predictive value support its use in reducing unnecessary CT imaging while accurately identifying children at risk for ciTBI.; Summary

Characteristics of Pediatric and Adolescent Trauma-Database Review of Single Level Trauma Center in Gangwon Province: Tae Han Lee, Pil Young Jung, Hye Youn Kwon, Hongjin Shim, Ji Young Jang, Keum Seok Bae, Seongyup Kim; J Trauma Inj. 2017;30(3):75-79. Published online October 30, 2017; DOI: https://doi.org/10.20408/jti.2017.30.3.75

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PURPOSE
Although trauma is the most common cause of death under age 18, Korean national pediatric trauma data has lack of clinical data. This study is to prepare manpower resources, equipment, and make a correct policy decision on pediatric trauma victims.
METHODS
The study enrolled 528 patients under age 16 with traumatic injury visited Wonju Severance Christian Hostpital Trauma Center, from February 12, 2015 to December 31, 2016. We analyzed the distribution of gender, age, place and time of the accident, injury mechanism, injury severity, and injured organ by medical record.
RESULTS
The major injury mechanisms were blunt injury in 485 (91.90%), penetrating injury in 27 (5.10%), burn in 13 (2.50%), near drowning in 2 (0.40%), and foreign body ingestion in 1 (0.20%). Ninety-seven (18.4%) patients were injured at home and 67 (12.7%) patients were injured at school. The overall mortality rate was 1.13% (n=6). 5 mortalities were related to automobile accident and one was fall down. Mean Injury Severity Score (ISS) was 4 (2, 8). No statistical significance was observed in the mean ISS between each age group. The peak time of accident occurrence was between 16 and 17 o'clock. The mean ISS was higher in blunt injury group than penetrating injury with statistical significance (6.50±7.60 vs. 3.00±8.10; p<0.05). The most common injury site was upper extremity. Mean ISS was highest in thorax injury. However, mean ISS of thorax injury was higher with statistical significance only compared with face, neck and upper extremity injury.
CONCLUSIONS
We reported our pediatric trauma patients data of our hospital level I trauma center, which is the only one level I trauma center of Gangwon Province. These data is useful to prevent and prepare for pediatric trauma.

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Citations

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Age group characteristics of children who visited a regional trauma center and analysis of factors affecting the severe trauma
Hyung Won Lee, Jea Yeon Choi, Jae Ho Jang, Jin Seong Cho, Sung Youl Hyun, Woo Sung Choi, Jae-Hyug Woo
Pediatric Emergency Medicine Journal.2020; 7(2): 94. CrossRef

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