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Minor Head Trauma Prediction Rules for head CT in children

Research Project

Project/Area Number 16K11436
Research Category

Grant-in-Aid for Scientific Research (C)

Allocation TypeMulti-year Fund
Section一般
Research Field Emergency medicine
Research InstitutionNational Center for Child Health and Development

Principal Investigator

UEMATSU SATOKO  国立研究開発法人国立成育医療研究センター, 総合診療部, 医師 (80632629)

Co-Investigator(Kenkyū-buntansha) 井手 健太郎  国立研究開発法人国立成育医療研究センター, 手術・集中治療部, その他 (60632627)
西村 奈穂  国立研究開発法人国立成育医療研究センター, 手術・集中治療部, 部長 (10650658)
Research Collaborator Kamizono Jyunnji  
Ito Tomoya  
Yamagami Hiroshi  
Funakoshi Hiraku  
Hagiwara Yusuke  
Tetsuhara Kenichi  
Kobayashi Tohru  
Mikami Masashi  
Project Period (FY) 2016-04-01 – 2019-03-31
Project Status Completed (Fiscal Year 2018)
Budget Amount *help
¥4,550,000 (Direct Cost: ¥3,500,000、Indirect Cost: ¥1,050,000)
Fiscal Year 2018: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000)
Fiscal Year 2017: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
Fiscal Year 2016: ¥1,820,000 (Direct Cost: ¥1,400,000、Indirect Cost: ¥420,000)
Keywords軽症頭部外傷 / 外傷性脳損傷 / CT撮影基準 / 小児 / 頭部CT検査 / 検査被曝 / 被曝
Outline of Final Research Achievements

The Pediatric Emergency Care Applied Research Network (PECARN) head trauma prediction rules identifying children who do not require cranial computed tomography (CT)were validated all over the world. These rules have not been validated with large cohort multi-center studies in Asia. We investigated whether the PECARN rules can be safely applied to Japanese. We conducted a multi-center, prospective, observational cohort study. We included children younger than 16 with minor head trauma (Glasgow Coma Scale above 14) between June 2016 and September 2017. We included 6585 children of which 463 had head CT scans performed and 23 (0.35%) had clinically important traumatic brain injury (ciTBI). Although, there were two patients with ciTBI who were classified as very low risk, the negative predictive value calculated as 99.96% was significantly superior compared with the preset threshold of 99.85%. The PECARN head trauma prediction rules seemed to be safely applicable to Japanese children.

Academic Significance and Societal Importance of the Research Achievements

小児の頭部外傷は救急外来を受診の理由で最も多いものの一つである.多くが軽症である中から臨床的に意義のある頭蓋内損傷を有する症例を見いだすことは重要である一方で,頭部CT撮影は検査被曝による発がんの危険性がある.よって,臨床的に意義のある頭蓋内損傷を見逃さない安全性を担保しつつ,医学的に不要な頭部CT撮影を最少限に抑えることが必要である.本研究では,頭蓋内尊称見逃しの安全性を担保し,検査被曝を抑えるためのCT撮影基準の妥当性を検証できた.このCT撮影基準の利用が普及すれば,子ども達への医学的な貢献と,未来がある子ども達への社会的貢献も大きい.

Report

(4 results)
  • 2018 Annual Research Report   Final Research Report ( PDF )
  • 2017 Research-status Report
  • 2016 Research-status Report
  • Research Products

    (2 results)

All 2018 2017

All Journal Article (1 results) (of which Int'l Joint Research: 1 results,  Peer Reviewed: 1 results) Presentation (1 results)

  • [Journal Article] External Validation of the PECARN Head Trauma Prediction Rules in Japan.2017

    • Author(s)
      Ide Kentaro, Uematsu Satoko, Tetsuhara Kenichi, et.al
    • Journal Title

      Acad Emerg Med

      Volume: 24 Issue: 3 Pages: 308-314

    • DOI

      10.1111/acem.13129

    • Related Report
      2017 Research-status Report
    • Peer Reviewed / Int'l Joint Research
  • [Presentation] 軽症頭部外傷小児対するPECARNルールの安全性の検討 ー多施設共同研究-2018

    • Author(s)
      井手健太郎
    • Organizer
      第46回日本救急医学会総会・学術集会
    • Related Report
      2018 Annual Research Report

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Published: 2016-04-21   Modified: 2020-03-30  

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