Comparison of CATCH, PECARN, and CHALICE clinical decision rules in pediatric patients with mild head trauma.

Abstract

The present study compares the most frequently used the CATCH, PECARN, and CHALICE clinical decision protocols with an aim to evaluate their effectiveness from the population perspective. This study included all patients under 18years of age presenting with blunt head trauma and a Glasgow Coma Scale score of 13 and higher for whom the attending physician decided to order head computed tomography scans, and the legal representative provided an informed consent for inclusion in the study. The PECARN, CATCH, and CHALICE clinical decision rules were applied to the participating patients, and the data for each of the three international clinical decision rules were recorded. These data were then compared to head CT results. Based on the head CT positivity, the sensitivity and specificity values for the PECARN were 82.76 and 45.03%; the sensitivity and specificity values for CATCH were 89.29 and 47.44%, showing statistical significance in predicting CT positivity; the CHALICE did not show statistical significance in detecting a pathological CT result. In terms of evaluating the need for hospitalization, the PECARN had a sensitivity of 83.87% and a specificity of 45.12%; the CATCH had a sensitivity of 90% and a specificity of 47.54%, showing statistical significance while the CHALICE did not significantly detect the need for hospitalization. The present study found that the PECARN and CATCH rules in children with minor head injury were significantly sensitive in detecting CT positivity and the need for hospitalization.