{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T06:21:19Z","timestamp":1781158879460,"version":"3.54.1"},"reference-count":10,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pediatr Emer Care"],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec>\n            <jats:title>Objective<\/jats:title>\n            <jats:p>The aim of the study was to evaluate the utility of the emergency department observation unit (EDOU) for neurologically intact children with closed head injuries (CHIs) and computed tomography (CT) abnormalities.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A retrospective cohort study of children aged 0 to 18 years with acute CHI, abnormal head CT, and a Glasgow Coma Scales score of 14 or higher admitted to the EDOU of a tertiary care children's hospital from 2007 to 2010. Children with multisystem trauma, nonaccidental trauma, and previous neurosurgical or coagulopathic conditions were excluded. Medical records were abstracted for demographic, clinical, and radiographic findings. Poor outcome was defined as death, intensive care unit admission, or medically\/surgically treated increased intracranial pressure.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Two hundred two children were included. Median (range) age was 14 (4 days-16 years) months; 51% were male. The most common CT findings were nondisplaced (136, 67%) or displaced (46, 23%) as well as skull fractures and subdural hematomas (38, 19%); 54 (27%) had less than 1 CT finding. The most common interventions included repeat CT (42, 21%), antiemetics (26, 13%), and pain medication (29, 14%). Eighty-nine percent were discharged in less than 24 hours. Inpatient admission from the EDOU occurred in 6 (3%); all were discharged in less than 3 days. One patient required additional intervention (corticosteroid therapy). She had a subdural hematoma, persistent vomiting, intractable headache, and a nonevolving CT.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Neurologically intact patients on initial ED evaluation had a very low likelihood of requiring further interventions, irrespective of CT findings. Although prospective evidence is necessary, this supports reliance on clinical findings when evaluating a well-appearing child with an acute CHI.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000000863","type":"journal-article","created":{"date-parts":[[2016,12,1]],"date-time":"2016-12-01T13:54:01Z","timestamp":1480600441000},"page":"161-165","source":"Crossref","is-referenced-by-count":5,"title":["Utility of Emergency Department Observation Units for Neurologically Intact Children With Head CT Abnormalities Secondary to Acute Closed Head Injury"],"prefix":"10.1097","volume":"33","author":[{"given":"Roxanna","family":"Lefort","sequence":"first","affiliation":[{"name":"From the *Sections of Emergency Medicine and Infectious Diseases, Departments of \u2020Radiology, \u2021Pediatrics, and \u00a7Neurosurgery, Baylor College of Medicine, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill V.","family":"Hunter","sequence":"additional","affiliation":[{"name":"From the *Sections of Emergency Medicine and Infectious Diseases, Departments of \u2020Radiology, \u2021Pediatrics, and \u00a7Neurosurgery, Baylor College of Medicine, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea T.","family":"Cruz","sequence":"additional","affiliation":[{"name":"From the *Sections of Emergency Medicine and Infectious Diseases, Departments of \u2020Radiology, \u2021Pediatrics, and \u00a7Neurosurgery, Baylor College of Medicine, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. Chantal","family":"Caviness","sequence":"additional","affiliation":[{"name":"From the *Sections of Emergency Medicine and Infectious Diseases, Departments of \u2020Radiology, \u2021Pediatrics, and \u00a7Neurosurgery, Baylor College of Medicine, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas G.","family":"Luerssen","sequence":"additional","affiliation":[{"name":"From the *Sections of Emergency Medicine and Infectious Diseases, Departments of \u2020Radiology, \u2021Pediatrics, and \u00a7Neurosurgery, Baylor College of Medicine, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aderonke","family":"Adekunle-Ojo","sequence":"additional","affiliation":[{"name":"From the *Sections of Emergency Medicine and Infectious Diseases, Departments of \u2020Radiology, \u2021Pediatrics, and \u00a7Neurosurgery, Baylor College of Medicine, Houston, TX."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"bib1-20230930","doi-asserted-by":"crossref","first-page":"e24","DOI":"10.1542\/peds.2011-2074","article-title":"US estimates of hospitalized children with severe traumatic brain injury: implications for clinical trials","volume":"129","year":"2012","journal-title":"Pediatrics"},{"key":"bib2-20230930","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/j.annemergmed.2013.02.027","article-title":"Isolated skull fractures: trends in management in US pediatric emergency departments","volume":"62","year":"2013","journal-title":"Ann Emerg Med"},{"key":"bib3-20230930","doi-asserted-by":"crossref","first-page":"2277","DOI":"10.1056\/NEJMra072149","article-title":"Computed tomography \u2013 an increasing source of radiation exposure","volume":"357","year":"2007","journal-title":"N Engl J Med"},{"key":"bib4-20230930","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1016\/S0140-6736(09)61558-0","article-title":"Identification of children at very low risk of clinically-important injuries after head trauma: a prospective cohort study","volume":"374","year":"2009","journal-title":"Lancet"},{"key":"bib5-20230930","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1503\/cmaj.091421","article-title":"CATCH: a clinical decision rule for the use of computed tomography in children with minor head injury","volume":"182","year":"2010","journal-title":"CMAJ"},{"key":"bib6-20230930","doi-asserted-by":"crossref","first-page":"1067","DOI":"10.1542\/peds.2010-3373","article-title":"The effect of observation on cranial computed tomography utilization for children after blunt head trauma","volume":"127","year":"2011","journal-title":"Pediatrics"},{"key":"bib7-20230930","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1001\/archpediatrics.2011.1156","article-title":"Prevalence of clinically important traumatic brain injuries in children with minor blunt head trauma and isolated severe injury mechanisms","volume":"166","year":"2012","journal-title":"Arch Pediatr Adolesc Med"},{"key":"bib8-20230930","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1016\/j.jpedsurg.2010.12.019","article-title":"Neurologically intact children with an isolated skull fracture may be safely discharged after brief observation","volume":"46","year":"2011","journal-title":"J Pediatr Surg"},{"key":"bib9-20230930","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1097\/01.pec.0000181426.25342.a9","article-title":"Pediatric closed head injuries treated in an observation unit","volume":"21","year":"2005","journal-title":"Pediatr Emerg Care"},{"issue":"5 Suppl","key":"bib10-20230930","first-page":"365","article-title":"Utility of serial computed tomography imaging in pediatric patients with head trauma","volume":"105","year":"2006","journal-title":"J Neurosurg"}],"container-title":["Pediatric Emergency Care"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.lww.com\/00006565-201703000-00004","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,30]],"date-time":"2023-09-30T08:11:26Z","timestamp":1696061486000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.lww.com\/00006565-201703000-00004"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3]]},"references-count":10,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2017]]}},"URL":"https:\/\/doi.org\/10.1097\/pec.0000000000000863","relation":{},"ISSN":["1535-1815","0749-5161"],"issn-type":[{"value":"1535-1815","type":"electronic"},{"value":"0749-5161","type":"print"}],"subject":[],"published":{"date-parts":[[2017,3]]}}}