Multicenter, Prospective Development of a Clinical Prediction Model to Determine Which Children Can Safely Avoid Abdominal CT Scanning During the Initial Evaluation of Blunt Abdominal Trauma
Purpose: The proposed project is a prospective, multi-institutional study involving data collection from initial Emergency Room evaluations of children following blunt abdominal trauma (BAT). Computed tomography (CT) is common in the initial trauma evaluation despite the potential for radiation-induced malignancy, associated cost of imaging, and the low incidence of intra-abdominal injury (IAI) requiring operative intervention. Radiation exposure is on the rise in children and may contribute to an increased risk of malignancy. Blunt abdominal trauma accounts for a significant proportion of CT scans obtained in the Pediatric Emergency Department. The aim is to develop and validate a clinical prediction model (CPM) that identifies patients at low risk for IAI in which advanced imaging can safely be avoided as a component of the initial trauma evaluation.
Procedures: This is a retrospective and prospective data collection study. Specific clinical variables have been incorporated into the History and Physical template that residents use when assessing patients during standard initial trauma evaluations. The data points will therefore be available in the patients’ electronic medical records (EMR) so research personnel can retrospectively collect and record these data.
Enrollment: Eleven Level One Pediatric Trauma Centers are being targeted as participants for this study. The goal for Children’s Memorial Hermann Hospital (CMHH) is to include data on 1500 patients, 250 IAI and 100 IAI requiring intervention in the initial 6 month to one year data collection period.