2018 Fiscal Year Final Research Report
Minor Head Trauma Prediction Rules for head CT in children
| Project/Area Number |
16K11436
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Multi-year Fund |
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| Section | 一般 |
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| Research Field |
Emergency medicine
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| Research Institution | National Center for Child Health and Development |
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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)
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| 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)
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| Research Collaborator |
Kamizono Jyunnji
Ito Tomoya
Yamagami Hiroshi
Funakoshi Hiraku
Hagiwara Yusuke
Tetsuhara Kenichi
Kobayashi Tohru
Mikami Masashi
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| Project Period (FY) |
2016-04-01 – 2019-03-31
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| Keywords | 軽症頭部外傷 / 外傷性脳損傷 / CT撮影基準 / 小児 |
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| 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.
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| Free Research Field |
小児救急医療
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| 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．
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