Cranial CT Recommended for Pediatric Polytrauma Patients with Glasgow Scale 13 or Less

There is no clinical variable that can be used as sole indication for WBCT in pediatric polytrauma patients.

A Glasgow Coma Scale (GCS) of 13 or under suggests that cranial CT (CCT) is recommended for pediatric polytrauma patients, according to a study published in the European Journal of Radiology.

Researchers from Germany sought to evaluate the diagnostic potential of the GCS, the mechanism of injury (MOI) and clinical examination (CE) for the indication of whole body CT (WBCT) in pediatric polytrauma patients.

The researchers analyzed data from 100 pediatric polytrauma patients, mean age 9.13 years who had undergone WBCT; 28 percent were female. Information on age, gender, MOI, GCS, detected injury, FAST, CE and Injury Severity Score (ISS) were all collected. Correlations between all clinical variables and patient groups with (p+) and without (p−) injury were assessed.

The results showed 71 percent of the patients were injured, the most common injury being of the head (43 percent). There was no significant correlation between type or severity of MOI and ISS. None of the clinical variables had a significant predictive effect on p+. The optimum discrimination threshold of GCS was at 12.5 relating to craniocerebral injuries. Severity of MOI and FAST showed best predictive effects on thoracic and abdominal pathologies, respectively, but with only low sensitivities (<20 percent).

The researchers concluded that there was no clinical variable that could be used as sole indication for WBCT in pediatric polytrauma patients, but GCS had a significant predictive value for craniocerebral injuries and CCT is recommended at GCS of 13 or less.