cliot (version 1.0.0)

pecarn_pediatric_iai_algorithm: PECARN Pediatric Intra-Abdominal Injury (IAI) Algorithm

Description

Calculates the risk of Intra-Abdominal Injury (IAI) requiring acute intervention in children with blunt torso trauma using the PECARN prediction rule. The algorithm identifies patients at very low risk (<0.1%) who may safely forego abdominal CT imaging.

Usage

pecarn_pediatric_iai_algorithm(abdominal_wall_trauma_seatbelt_sign, gcs_lt_14,
                               abdominal_tenderness, thoracic_wall_trauma,
                               abdominal_pain, decreased_breath_sounds, vomiting)

Value

A list containing:

PECARN_IAI_Risk_Factors

The total count of positive predictors present.

Risk_Category

Classification (Very Low Risk vs. Not Very Low Risk).

Risk_of_Intervention

Estimated probability of IAI requiring acute intervention (laparotomy, angiographic embolization, blood transfusion, or IV fluids for >2 nights).

Arguments

abdominal_wall_trauma_seatbelt_sign

Numeric (0 or 1). Evidence of abdominal wall trauma or seatbelt sign (bruising, abrasion). (1 = Yes).

gcs_lt_14

Numeric (0 or 1). Glasgow Coma Scale score < 14 (i.e., 13 or lower). (1 = Yes).

abdominal_tenderness

Numeric (0 or 1). Presence of abdominal tenderness on examination (mild, moderate, or severe). (1 = Yes).

thoracic_wall_trauma

Numeric (0 or 1). Evidence of thoracic wall trauma (pain, tenderness, contusion, abrasion). (1 = Yes).

abdominal_pain

Numeric (0 or 1). Patient complaint of abdominal pain. (1 = Yes).

decreased_breath_sounds

Numeric (0 or 1). Decreased or absent breath sounds on auscultation. (1 = Yes).

vomiting

Numeric (0 or 1). Any vomiting associated with the trauma. (1 = Yes).

References

Holmes JF, Lillis K, Monroe D, et al. Identifying children at very low risk of clinically important blunt abdominal injuries. Ann Emerg Med. 2013;62(2):107-116.e2. doi:10.1016/j.annemergmed.2012.11.009

Examples

# Example 1: Very Low Risk
# No symptoms or signs
pecarn_pediatric_iai_algorithm(0, 0, 0, 0, 0, 0, 0)

# Example 2: Not Very Low Risk
# Seatbelt sign (1), Abdominal pain (1)
# Score = 2
pecarn_pediatric_iai_algorithm(1, 0, 0, 0, 1, 0, 0)