The Infant Scalp Score: A Validated Tool to Stratify Risk of Traumatic Brain Injury in Infants With Isolated Scalp Hematoma.

Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
Sara SchutzmanRebekah Mannix

Abstract

The objective was to validate the previously derived Infant Scalp Score (ISS) that uses clinical signs in infants with isolated scalp hematoma (ISH) after head trauma to stratify risk for clinically important traumatic brain injury (ciTBI) or TBI on computed tomography (CT). Using the publicly available Pediatric Emergency Care Applied Research Network TBI data set, we selected infants ≤ 1 year with GCS 14 to 15 who had ISH (defined as hematoma without other signs/symptoms of TBI). CT scans were obtained at the treating physician's discretion. We calculated ISS based on age, hematoma size, and location (range = 0-8) for each patient and calculated the sensitivity and specificity of the score for ciTBI and TBI on CT across a range of ISS cut-points. We included 1,289 infants ≤ 1 year of whom 462 (36%) had CT performed. Twelve had ciTBI and 59 had TBI on CT. An ISS cutoff ≥ 4 had sensitivity of 100% for ciTBI (95% confidence interval [CI] = 0.74 to 1.0) and TBI with specificity of 0.49 (95% CI = 0.46 to 0.51). An ISS cutoff of ≥5 had a sensitivity of 100% for ciTBI (95% CI = 0.74 to 1.0) and specificity of 0.68 (95% CI = 0.66 to 0.71), but missed three infants with TBI on CT (none of whom required intervention). The receiver oper...Continue Reading

References

May 4, 2001·Pediatric Emergency Care·D S Greenes, S A Schutzman
May 31, 2002·Journal of Pediatric Surgery·Madan Samuel
Jun 5, 2003·Pediatrics·David M RubinDennis R Durbin
Oct 24, 2006·Archives of Disease in Childhood·J DunningUNKNOWN Children's head injury algorithm for the prediction of important clinical events study group
Feb 27, 2009·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Marc H GorelickUNKNOWN Pediatric Emergency Care Applied Research Network
Sep 18, 2009·Lancet·Nathan KuppermannUNKNOWN Pediatric Emergency Care Applied Research Network (PECARN)
Feb 10, 2010·CMAJ : Canadian Medical Association Journal = Journal De L'Association Medicale Canadienne·Martin H OsmondUNKNOWN Pediatric Emergency Research Canada (PERC) Head Injury Study Group
Sep 2, 2010·Pediatric Emergency Care·Steven S BinDavid S Greenes
May 11, 2011·Pediatrics·Lise E NigrovicUNKNOWN Traumatic Brain Injury Group for the Pediatric Emergency Care Applied Research Network
Mar 19, 2014·Annals of Emergency Medicine·Peter S DayanUNKNOWN Traumatic Brain Injury Study Group of the Pediatric Emergency Care Applied Research Network (PECARN)
Mar 8, 2016·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Emma C M BurnsUNKNOWN Pediatric Emergency Research Canada (PERC) Head Injury Study Group
Nov 20, 2016·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Kentaro IdeTohru Kobayashi
Sep 6, 2018·Pediatrics·Brett BursteinMark I Neuman
Mar 6, 2019·Archives of Disease in Childhood·Silvia BressanUNKNOWN Paediatric Research in Emergency Department International Collaborative (PREDICT) group
Mar 30, 2019·Pediatric Radiology·Thomas R GoodmanErin Rowe

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Citations

Jun 22, 2021·Annals of Emergency Medicine·Zaynah AbidPeter S Dayan

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