Background & Objective:
Whole-Body Computed Tomography (PANSCAN) use in paediatric trauma remains controversial, due to the well-known challenge to balance injury detection against radiation exposure. Recent studies have identified specific predictors for PANSCAN use in paediatric trauma, with Glasgow Coma Scale (GCS) showing consistent predictive value. Our study aimed to evaluate the predictive value of GCS and other clinical variables in a level-1 Paediatric Trauma Center at Children's Hospital at Westmead (CHW) in New South Wales.
Method:
Data from 64 patients who underwent PANSCAN between 2016 and 2021 at CHW's Paediatric Trauma Center were analysed. Demographic, injury- and hospital-related variables were examined using univariate statistical analyses. Logistic regression was employed to identify potential predictors of clinically significant PANSCAN pathology (p+) versus those without (p-).
Results:
Contrary to recent findings by Strahl et al. (Injury, March 2024), our study did not identify any variables with significant predictive value for PANSCAN use in paediatric trauma patients. Notably, external signs were consistently significant as the sole indication for region-specific p+ findings in head/neck and face areas, while GCS was not a significant predictor.
Conclusions:
Our findings suggest that predictive factors for PANSCAN use may vary across different paediatric trauma settings. External signs, rather than GCS, were found to be significant indicators for certain region-specific findings. These results highlight the need for institution-specific protocols and further research to optimise PANSCAN use in paediatric trauma. The study underscores the importance of considering local patient populations and injury patterns when developing guidelines for PANSCAN utilisation.