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Table 1 Characteristics of patients presenting with head trauma pre- and post-PECARN rules implementation

From: Does implementation of the PECARN rules for minor head trauma improve patient-centered outcomes in a lower resource emergency department: a retrospective cohort study

Variables

Pre-PECARN

(N = 425)

Post-PECARN

(N = 937)

p-value

Age, in years, mean (±SD)

4.75 (± 4.67)

4.42 (± 4.44)

0.21

Age, in years, n (%)

  < 2

135 (31.8)

309 (33.0)

0.66

  ≥ 2

290 (68.2)

628 (67.0)

Male, mean (±SD)

254 (59.8)

534 (57.0)

0.34

Severe mechanism of injurya, n (%)

16 (3.8)

35 (3.7)

0.98

Symptoms, n (%)

 Dizziness

26 (6.1)

54 (5.8)

0.8

 Vertigo

2 (0.5)

0 (0.0)

0.04

 Amnesia

11 (2.6)

18 (1.9)

0.43

 Nausea

15 (3.5)

27 (2.9)

0.52

 Vomiting

68 (16.0)

136 (14.5)

0.48

 Seizure

4 (0.9)

8 (0.9)

0.87

 Vision changes

3 (0.7)

13 (1.4)

0.3

 Altered mental statusb

34 (8.0)

39 (4.2)

0.004

 Severe headache

9 (2.1)

19 (2.0)

0.91

 LOC

20 (4.7)

39 (4.2)

0.65

 LOC > 5 s

17 (4.0)

20 (2.1)

0.05

Physical Exam findings, n (%)

 Scalp Occipital/Parietal/Temporal Hematoma

19 (4.5)

44 (4.7)

0.86

 Palpable skull fracture

0 (0.0)

1 (0.1)

0.5

 Signs of basilar skull fracturec

1 (0.2)

1 (0.1)

0.57

 Not acting normally as per parent

9 (2.1)

36 (3.8)

0.1

 Altered mental status

17 (4.0)

38 (4.1)

0.96

 GCS 14

2 (0.5)

2 (0.2)

0.7

GCS 15

417 (98.1)

920 (98.2)

Risk Stratification, n (%)

Low Risk

338 (79.5)

752 (80.3)

0.94

  < 2

116 (34.3)

264 (35.1)

0.8

  ≥ 2

222 (65.7)

488 (64.9)

Intermediate Risk

69 (16.2)

145 (15.5)

0.94

  < 2

13 (18.8)

29 (20.0)

0.84

  ≥ 2

56 (81.2)

116 (80.0)

High Risk

18 (4.2)

40 (4.2)

0.94

  < 2

6 (33.3)

16 (40.0)

0.63

  ≥ 2

12 (66.7)

24 (60.0)

  1. aSevere mechanism of injury: motor vehicle crash with patient ejection, death of another passenger, or rollover; pedestrian or bicyclist without helmet struck by a motorized vehicle; falls of more than 0.9 m (if < 2 years of age) or more than 1.5 m (if more than 2 years of age); or head struck by a high-impact object
  2. bAltered mental status: agitation, somnolence, repetitive questioning, or slow response to verbal communication [4]
  3. cSigns of basilar skull fracture included the battle’s sign, racoon eyes, hemotympanum, cerebral spinal fluid otorrhea, or cerebral spinal fluid rhinorrhea [4]