{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T20:15:24Z","timestamp":1791317724218,"version":"4.3.1"},"reference-count":9,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2015,3,16]],"date-time":"2015-03-16T00:00:00Z","timestamp":1426464000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000102","name":"Health Resources and Services Administration","doi-asserted-by":"publisher","award":["1H34MC04372-01-00"],"award-info":[{"award-number":["1H34MC04372-01-00"]}],"id":[{"id":"10.13039\/100000102","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2015,4]]},"abstract":"Abstract<\/jats:title>Objectives<\/jats:title>The Pediatric Emergency Care Applied Research Network (PECARN<\/jats:styled-content>) investigators previously identified risk factors associated with cervical spine injuries (CSI<\/jats:styled-content>s) in children. Anatomic maturation and age\u2010related variation in mechanisms of injury suggested the need to explore factors separately for younger versus older children. The purpose of this substudy was to investigate CSI<\/jats:styled-content> risk factors in age subgroups within the PECARN<\/jats:styled-content> study cohort.<\/jats:p><\/jats:sec>Methods<\/jats:title>This was an age\u2010stratified case\u2010control analysis of children younger than 16 years presenting to 17 PECARN<\/jats:styled-content> hospitals following blunt trauma between January 1, 2000 and December 31, 2004. Data were abstracted for children with CSI<\/jats:styled-content>s and randomly selected CSI<\/jats:styled-content>\u2010free children. Age\u2010stratified multivariable logistic regression was performed to identify factors associated with CSI<\/jats:styled-content> within three age groups: younger than 2, 2 to 7, and 8 to 15 years. Sensitivity and specificity for CSI<\/jats:styled-content> were estimated for both the age\u2010specific and original (altered mental status, focal neurologic findings, neck pain, torticollis, substantial torso injury, predisposing conditions, diving, and high\u2010risk motor vehicle crash [MVC<\/jats:styled-content>]) models.<\/jats:p><\/jats:sec>Results<\/jats:title>Among 540 children with CSI<\/jats:styled-content>s, 27 were younger than 2 years, 140 were 2 to 7 years, and 373 were 8 to 15 years. Focal neurologic deficits and high\u2010risk MVC<\/jats:styled-content> were associated with CSI<\/jats:styled-content>s in all age\u2010specific models. Other age\u2010specific factors included the following: younger than 2 years, none; 2 to 7 years, altered mental status, neck pain, torticollis; and 8 to 15 years, altered mental status, neck pain, diving. Age\u2010specific models had comparable sensitivity to the original model among the older groups, but had lower sensitivity and higher specificity among the youngest children.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>While this analysis supports the original PECARN<\/jats:styled-content> model for CSI<\/jats:styled-content>, there were subtle age variations in factors associated with CSI<\/jats:styled-content>s in children that warrant future investigation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.12637","type":"journal-article","created":{"date-parts":[[2015,3,17]],"date-time":"2015-03-17T00:28:17Z","timestamp":1426552097000},"page":"441-446","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Age\u2010related Differences in Factors Associated With Cervical Spine Injuries in Children"],"prefix":"10.1111","volume":"22","author":[{"given":"Julie C.","family":"Leonard","sequence":"first","affiliation":[{"name":"The Department of Pediatrics Division of Emergency Medicine Washington University in St. Louis School of Medicine St. Louis Children's Hospital St. Louis MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David M.","family":"Jaffe","sequence":"additional","affiliation":[{"name":"The Department of Pediatrics Division of Emergency Medicine Washington University in St. Louis School of Medicine St. Louis Children's Hospital St. Louis MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cody S.","family":"Olsen","sequence":"additional","affiliation":[{"name":"The Central Data Management and Coordinating Center University of Utah School of Medicine Salt Lake City UT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan","family":"Kuppermann","sequence":"additional","affiliation":[{"name":"The Departments of Emergency Medicine and Pediatrics University of California Davis School of Medicine, University of California, Davis Medical Center Sacramento CA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2015,3,16]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.108.2.e20"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2010.08.038"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(87)80171-3"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpedi.1987.04460020089033"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3181b57aa1"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-3505"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1526-4610.2000.00004.x"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1553-2712.2007.tb01856.x"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/BPO.0000000000000167"}],"container-title":["Academic Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Facem.12637","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.12637","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,11]],"date-time":"2023-09-11T13:40:23Z","timestamp":1694439623000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/acem.12637"}},"subtitle":[],"editor":[{"given":"Bema","family":"Bonsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2015,3,16]]},"references-count":9,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2015,4]]}},"alternative-id":["10.1111\/acem.12637"],"URL":"https:\/\/doi.org\/10.1111\/acem.12637","archive":["Portico"],"relation":{},"ISSN":["1069-6563","1553-2712"],"issn-type":[{"value":"1069-6563","type":"print"},{"value":"1553-2712","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,3,16]]},"assertion":[{"value":"2014-08-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-11-20","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-03-16","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}