{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T01:51:53Z","timestamp":1778550713744,"version":"3.51.4"},"reference-count":24,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,3,4]],"date-time":"2019-03-04T00:00:00Z","timestamp":1551657600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Paediatrica"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aim<\/jats:title><jats:p>Our primary aim was to calculate the head computed tomography (<jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content>) scan rate in children with a minor head injury (<jats:styled-content style=\"fixed-case\">MHI<\/jats:styled-content>) when the Dutch National guidelines were followed in clinical practice. The secondary aim was to determine the incidence of <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> abnormalities and the guideline predictors associated with traumatic abnormalities.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a multi\u2010centre, prospective observational cross\u2010sectional study in the emergency departments of six hospitals in The Netherlands between 1 April 2015 and 31 December 2016.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Data on 1002 patients were studied and 69% of cases complied with the guidelines. The overall <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> rate was 44% and the incidence of traumatic abnormal <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> findings was 13%. <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> scans were performed in 19% of children under two years of age, 48% of children between two and five years and 63% of children aged six years or more. Multivariate regression analysis for all age categories showed that <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> abnormalities were predicted by a Glasgow Coma Scale of less than 15, suspicion of a basal skull fracture, vomiting and scalp haematomas or external lesions of the skull.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Strict adherence to the Dutch national guidelines resulted in <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> overuse. New guidelines are needed to safely reduce <jats:styled-content style=\"fixed-case\">CT<\/jats:styled-content> scan indications.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apa.14742","type":"journal-article","created":{"date-parts":[[2019,2,5]],"date-time":"2019-02-05T20:34:30Z","timestamp":1549398870000},"page":"1695-1703","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Multi\u2010centre study found that strict adherence to guidelines led to computed tomography scans being overused in children with minor head injuries"],"prefix":"10.1111","volume":"108","author":[{"given":"Nicky","family":"Niele","sequence":"first","affiliation":[{"name":"Department of Paediatrics Tergooi Hospital Blaricum The Netherlands"},{"name":"Department of Paediatrics Emma Children's Hospital Amsterdam UMC Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marlies A.","family":"van Houten","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Spaarne Gasthuis Hospital Hoofddorp The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bart","family":"Boersma","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Noordwest Ziekenhuisgroep Alkmaar The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maarten H.","family":"Biezeveld","sequence":"additional","affiliation":[{"name":"Department of Paediatrics OLVG\u2010Oost Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthijs","family":"Douma","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine Dijklander Hospital Hoorn The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katja","family":"Heitink","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Flevo Hospital Almere The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gavin W.","family":"ten Tusscher","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Dijklander Hospital Hoorn The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ellen","family":"Tromp","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Statistics St Antonius Hospital Nieuwegein The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Johannes B.","family":"van Goudoever","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Emma Children's Hospital Amsterdam UMC Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3212-2048","authenticated-orcid":false,"given":"Frans B.","family":"Pl\u00f6tz","sequence":"additional","affiliation":[{"name":"Department of Paediatrics Tergooi Hospital Blaricum The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,3,4]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61558-0"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.091421"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2005.083980"},{"key":"e_1_2_10_5_1","unstructured":"NeurologieNVv.Richtlijn opvang pati\u00ebnten met licht traumatisch hoofd\/hersenletsel. 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