Criterios para la toma de decisión de TC en pacientes pediátricos con trauma craneoencefálico leve en el Hospital del Niño Dr. Francisco Icaza Bustamante período 2019 – 2020.

Abstract

Introduction: Head or brain injury (TBI) is an injury to the skull or its contents due to an external impact that, depending on the strength and magnitude and according to its severity, can be classified as mild, moderate, or severe. The Glasgow scale is used to distinguish between them: mild TBI Glasgow of 14-15, moderate 13-9 and severe <8. The use of CT scans in children is associated with an increased risk of cancer, particularly leukemias and brain tumors. Objective: To establish the general use criteria for CT decision making in pediatric patients with mild TBI at the Hospital del Niño Dr. Francisco De Icaza Bustamante, during the year 2019 to 2020. Methodology: Observational, Retrospective, Transversal and Analytical. Results: During the 2019-2020 period, at the Francisco de Icaza Bustamante Hospital, children under 2 years of age underwent a CT scan 94% of the times they arrived with symptoms suggestive of mild TBI. In children older than 2 years, a CT scan was performed 93% of the time. In this study, the mechanism of injury and the criteria used for CT decision-making in patients with mild TBI in the pediatric HFIB population were determined. The criteria most used to perform a CT scan were the presence or absence of skull base fracture, open wound, seizures, palpable skull fracture, loss of consciousness, sphincter relaxation, vomiting, subgaleal hematoma, and headaches. To evaluate the clinical utility of the variables used, the sensitivity, specificity, positive predictive value and negative predictive value of the criteria used by hospital physicians were calculated.