Clinical Decision Rule to Identify Children with Intra-Abdominal Injuries
识别腹内损伤儿童的临床决策规则
基本信息
- 批准号:7281247
- 负责人:
- 金额:$ 44.99万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2006
- 资助国家:美国
- 起止时间:2006-09-01 至 2009-08-31
- 项目状态:已结题
- 来源:
- 关键词:
项目摘要
Trauma is the leading cause of death in children and intra-abdominal injuries (IAI) are a frequent
cause of morbidity and mortality due to trauma. Some IAIs are difficult to identify and failure to identify these
injuries results in preventable morbidity and mortality. Abdominal computerized tomography (CT) is the
reference standard for the diagnosis of IAl. CT scanning, however, has important risks, primarily the risk of
development of radiation-induced malignancy. For every 1,500 children undergoing abdominal CT scanning,
approximately one child will die from a malignancy induced by the radiation and up to three additional
children will develop non-fatal malignancies from this exposure. Only approximately 10% of abdominal CT scans currently performed on children with trauma demonstrate IAIs, thus CT scanning is used inefficiently. Objectives: The
objective of this study is to develop highly sensitive, specific and generalizable decision rules for the
evaluation of children seen in emergency departments (EDs) with blunt abdominal trauma. These decision
rules may then serve to generate evidence-driven guidelines for the evaluation of these children, and when
implemented will result in more efficient use of CT scans. Study Design: This will be a prospective,
multicenter, observational study of children with blunt abdominal trauma. Setting: Children with blunt
abdominal trauma seen at one of 17 hospitals in the Pediatric Emergency Care Applied Research Network
(PECARN) will be enrolled over a two year period. The EDs of the PECARN evaluate more than 900,000
children of diverse geographic and racial/ethnic background annually. Participants: We will enroll approximately 9,774
children with significant blunt torso trauma, including 900 children with IAl. Outcome Measures: The primary
outcome for this study will be IAI in need of acute intervention (IAI resulting in death, or an IAI in need of any
of the following: laparotomy, blood transfusion, angiographic embolization, or IV hydration).
Interventions/Data analysis: The patients' history, physical examination findings and laboratory results at ED
evaluation will be analyzed using recursive partitioning to generate a clinical decision rule(s) for the
identification of children at high risk and near-zero risk of IAI in need of acute intervention. The decision rule
(s) will lead to more efficient use of abdominal CT in those children at risk for IAIs, and a decrease in use in
those at near-zero risk of IAI, ultimately resulting in more efficient, safe and effective care of injured children.
创伤是儿童死亡的主要原因,腹腔内损伤(IAI)是常见的
创伤导致的发病率和死亡率。有些独立审计机构难以确定,
伤害导致可预防的发病率和死亡率。腹部计算机断层扫描(CT)是
用于诊断IAL的参考标准。然而,CT扫描具有重要的风险,主要是
辐射诱发的恶性肿瘤。每1,500名接受腹部CT扫描的儿童,
大约一名儿童将死于辐射引起的恶性肿瘤,
儿童将因接触这种物质而患上非致命性恶性肿瘤。目前对创伤儿童进行的腹部CT扫描中,只有约10%显示IAI,因此CT扫描的使用效率低下。目标:The
本研究的目的是开发高度敏感,具体和概括的决策规则,
评估急诊科(ED)中的钝性腹部创伤儿童。这些决策
然后,规则可以用于生成证据驱动的指南来评估这些儿童,以及何时
这将导致更有效地使用CT扫描。研究设计:这将是一项前瞻性研究,
儿童腹部钝性创伤的多中心观察性研究。设置:儿童钝
在儿科急诊应用研究网络的17家医院之一看到的腹部创伤
(PECARN)将在两年时间内注册。PECARN的ED评估超过90万
不同地理和种族/民族背景的儿童。参与者:我们将招募约9,774人
严重钝性躯干创伤的儿童,包括900名患有IAL的儿童。结果指标:主要
这项研究的结果将是需要急性干预的IAI(导致死亡的IAI,或需要任何治疗的IAI)。
剖腹手术、输血、血管造影栓塞或IV水化)。
干预/数据分析:患者的病史、艾德的体格检查结果和实验室结果
将使用递归分区对评价进行分析,以生成用于
确定需要紧急干预的IAI高风险和接近零风险的儿童。所述决策规则
(s)将导致在有IAI风险的儿童中更有效地使用腹部CT,
这些人患IAI的风险几乎为零,最终导致对受伤儿童的更有效,更安全和更有效的护理。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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James F. Holmes其他文献
Hepatic enzyme decline after pediatric blunt trauma: A tool for timing child abuse?
- DOI:
10.1016/j.chiabu.2007.09.013 - 发表时间:
2008-09-01 - 期刊:
- 影响因子:
- 作者:
Amy L. Baxter;Daniel M. Lindberg;Bonnie L. Burke;Justine Shults;James F. Holmes - 通讯作者:
James F. Holmes
Erratum to: Pediatric emergency medicine point-of-care ultrasound: summary of the evidence
- DOI:
10.1186/s13089-017-0058-z - 发表时间:
2017-02-03 - 期刊:
- 影响因子:2.900
- 作者:
Jennifer R. Marin;Alyssa M. Abo;Alexander C. Arroyo;Stephanie J. Doniger;Jason W. Fischer;Rachel Rempell;Brandi Gary;James F. Holmes;David O. Kessler;Samuel H. F. Lam;Marla C. Levine;Jason A. Levy;Alice Murray;Lorraine Ng;Vicki E. Noble;Daniela Ramirez-Schrempp;David C. Riley;Turandot Saul;Vaishali Shah;Adam B. Sivitz;Ee Tein Tay;David Teng;Lindsey Chaudoin;James W. Tsung;Rebecca L. Vieira;Yaffa M. Vitberg;Resa E. Lewiss - 通讯作者:
Resa E. Lewiss
Clinical Presentations and Outcomes of Children With Basilar Skull Fractures After Blunt Head Trauma
- DOI:
10.1016/j.annemergmed.2016.04.058 - 发表时间:
2016-10-01 - 期刊:
- 影响因子:
- 作者:
Michael G. Tunik;Elizabeth C. Powell;Prashant Mahajan;Jeff E. Schunk;Elizabeth Jacobs;Michelle Miskin;Sally Jo Zuspan;Sandra Wootton-Gorges;Shireen M. Atabaki;John D. Hoyle;James F. Holmes;Peter S. Dayan;Nathan Kuppermann;M. Gerardi;M. Tunik;J. Tsung;K. Melville;L. Lee;P. Mahajan;P. Dayan - 通讯作者:
P. Dayan
ACR Appropriateness Criteria® Penetrating Torso Trauma
ACR 适宜性标准®穿透性躯干创伤
- DOI:
10.1016/j.jacr.2024.08.014 - 发表时间:
2024-11-01 - 期刊:
- 影响因子:5.100
- 作者:
Expert Panel on Polytrauma Imaging;James T. Lee;Ahmed Sobieh;Stephanie Bonne;Marc A. Camacho;Phyllis Glanc;James F. Holmes;Sanjeeva P. Kalva;Faisal Khosa;Krista Perry;Susan B. Promes;Thomas Ptak;Eric A. Roberge;LeAnn Shannon;Edwin F. Donnelly - 通讯作者:
Edwin F. Donnelly
Incidental Findings on Computed Tomography in Children With Blunt Abdominal Trauma
儿童腹部钝性创伤计算机断层扫描的偶然发现
- DOI:
10.1016/j.annemergmed.2024.12.012 - 发表时间:
2025-05-01 - 期刊:
- 影响因子:5.000
- 作者:
Irma T. Ugalde;Kenneth Yen;Grant Tatro;Paul Ishimine;Nisa S. Atigapramoj;Pradip P. Chaudhari;Kevan A. McCarten-Gibbs;Mohamed Badawy;Jeffrey S. Upperman;Nathan Kuppermann;James F. Holmes - 通讯作者:
James F. Holmes
James F. Holmes的其他文献
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{{ truncateString('James F. Holmes', 18)}}的其他基金
A randomized controlled trial of abdominal ultrasound (FAST) in children with blunt torso trauma
躯干钝性创伤儿童腹部超声 (FAST) 的随机对照试验
- 批准号:
10522284 - 财政年份:2022
- 资助金额:
$ 44.99万 - 项目类别:
A randomized controlled trial of abdominal ultrasound (FAST) in children with blunt torso trauma
躯干钝性创伤儿童腹部超声 (FAST) 的随机对照试验
- 批准号:
10700074 - 财政年份:2022
- 资助金额:
$ 44.99万 - 项目类别:
Validation of Decision Rules for CT Use in Children with Abdominal or Head Trauma
腹部或头部创伤儿童 CT 使用决策规则的验证
- 批准号:
9177011 - 财政年份:2016
- 资助金额:
$ 44.99万 - 项目类别:
DANGER: Developing the Next Generation of Emergency Medicine Researchers
危险:培养下一代急诊医学研究人员
- 批准号:
8270461 - 财政年份:2011
- 资助金额:
$ 44.99万 - 项目类别:
DANGER: Developing the Next Generation of Emergency Medicine Researchers
危险:培养下一代急诊医学研究人员
- 批准号:
8715386 - 财政年份:2011
- 资助金额:
$ 44.99万 - 项目类别:
DANGER: Developing the Next Generation of Emergency Medicine Researchers
危险:培养下一代急诊医学研究人员
- 批准号:
8164097 - 财政年份:2011
- 资助金额:
$ 44.99万 - 项目类别:
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