PURPOSE The PECARN head trauma (HT) prediction rules have been developed to guide computed tomography-related decision-making for children with minor HT (mHT). There are currently limited data on the rate of unscheduled revisits to emergency departments (EDs), and initially missed intracranial injuries, in children with mHT initially assessed using the PECARN rules. This study aimed to fill this gap in knowledge. METHODS Clinical charts of children assessed for mHT over a 5-year period at two EDs that implemented the PECARN rules in Italy and France were reviewed retrospectively. Children who returned to EDs for mHT-related, or potentially related complaints, within 1 month of initial assessment were included. RESULTS The total number of children with mHT presenting for the first time to the EDs of both sites was 11,749. Overall, 180 (1.5%) unscheduled revisits to the EDs occurred for mHT-related or potentially related complaints. Twenty-three of these 180 patients underwent neuroimaging, and seven had an intracranial injury (including one ischemic stroke). Of these, three were hospitalized and none needed neurosurgery or intensive care. CONCLUSION Unscheduled revisits for mHT in EDs using the PECARN rules were very uncommon. Initially missed intracranial injuries were rare, and none needed neurosurgery or intensive care.

中文翻译：

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在使用 PECARN 颅脑损伤决策规则的急诊科中，漏诊颅内损伤的情况很少见。

目的 PECARN 头部外伤 (HT) 预测规则已被开发用于指导针对轻微 HT (mHT) 儿童的计算机断层扫描相关决策。对于最初使用 PECARN 规则评估的 mHT 儿童，目前关于计划外再次访问急诊室 (ED) 和最初漏诊颅内损伤的数据有限。本研究旨在填补这一知识空白。方法 回顾性审查了在意大利和法国实施 PECARN 规则的两个 ED 中 5 年期间评估 mHT 的儿童的临床图表。包括在初始评估后 1 个月内因 mHT 相关或潜在相关投诉而返回急诊室的儿童。结果 首次就诊于两个地点急诊室的 mHT 患儿总数为 11,749 人。总的来说，180（1。5%) 因 mHT 相关或可能相关的投诉而对 ED 进行计划外重访。这 180 名患者中有 23 名接受了神经影像学检查，其中 7 名患有颅内损伤（包括 1 名缺血性中风）。其中 3 人住院，没有人需要神经外科手术或重症监护。结论 使用 PECARN 规则在 ED 中计划外的 mHT 复诊非常少见。最初错过的颅内损伤很少见，不需要神经外科手术或重症监护。结论 使用 PECARN 规则在 ED 中计划外的 mHT 复诊非常少见。最初错过的颅内损伤很少见，不需要神经外科手术或重症监护。结论 使用 PECARN 规则在 ED 中计划外的 mHT 复诊非常少见。最初错过的颅内损伤很少见，不需要神经外科手术或重症监护。