ArticleBMC medicine2018
External validation of the Scandinavian guidelines for management of minimal, mild and moderate head injuries in children.
Article in BMC medicine, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.
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15 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Pooled it
- Regional differences in the management of patients with mild traumatic brain injury and antithrombotic therapy-an Austrian survey.Archives of orthopaedic and trauma surgery · 2026Article
- Article
- Acute interleukin-10 predicts persistent post-concussion symptoms in children with mild traumatic brain injury: exploratory findings from the t-BIOMAP study.Frontiers in neurology · 2026Article
- Comparison of predictive tools for management of paediatric mild TBI: a prospective cohort study.EClinicalMedicine · 2025Article
- Diagnostic accuracy of the Scandinavian guidelines for minor and moderate head trauma in children: a prospective, pragmatic, validation study.The Lancet regional health. Europe · 2025Article
- Clinical characteristics associated with pediatric traumatic intracranial hemorrhage.Chinese journal of traumatology = Zhonghua chuang shang za zhi · 2024Article
- Pediatric head injury guideline use in Sweden: a cross-sectional survey on determinants for successful implementation of a clinical practice guideline.BMC health services research · 2024Article
- Observational
- Diagnostic potential of IL6 and other blood-based inflammatory biomarkers in mild traumatic brain injury among children.Frontiers in neurology · 2024Article
- Management of Pediatric Mild Traumatic Brain Injury Patients: S100b, Glial Fibrillary Acidic Protein, and Heart Fatty-Acid-Binding Protein Promising Biomarkers.Neurotrauma reports · 2024Article
- The epidemiology of and management of pediatric patients with head trauma: a hospital-based study from Southern Sweden.Scandinavian journal of trauma, resuscitation and emergency medicine · 2022Article
- Management of paediatric traumatic brain injury in Sweden: a national cross-sectional survey.Scandinavian journal of trauma, resuscitation and emergency medicine · 2022Article
- Implementation of the S100 Calcium-Binding Protein B Biomarker in a Clinical Setting: A Retrospective Study of Benefits, Safety, and Effectiveness.Neurotrauma reports · 2022Article
- Validation of the scandinavian guidelines for initial management of minor and moderate head trauma in children.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2021Article
Corrections and comments
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Authors and funding
16 authors at 12 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundClinical decision rules (CDRs) aid in the management of children with traumatic brain injury (TBI). Recently, the Scandinavian Neurotrauma Committee (SNC) has published practical, evidence-based guidelines for children with Glasgow Coma Scale (GCS) scores of 9-15. This study aims to validate these guidelines and to compare them with other CDRs.
methodsA large prospective cohort of children (< 18 years) with TBI of all severities, from ten Australian and New Zealand hospitals, was used to assess the SNC guidelines. Firstly, a validation study was performed according to the inclusion and exclusion criteria of the SNC guideline. Secondly, we compared the accuracy of SNC, CATCH, CHALICE and PECARN CDRs in patients with GCS 13-15 only. Diagnostic accuracy was calculated for outcome measures of need for neurosurgery, clinically important TBI (ciTBI) and brain injury on CT.
resultsThe SNC guideline could be applied to 19,007/20,137 of patients (94.4%) in the validation process. The frequency of ciTBI decreased significantly with stratification by decreasing risk according to the SNC guideline. Sensitivities for the detection of neurosurgery, ciTBI and brain injury on CT were 100.0% (95% CI 89.1-100.0; 32/32), 97.8% (94.5-99.4; 179/183) and 95% (95% CI 91.6-97.2; 262/276), respectively, with a CT/admission rate of 42% (mandatory CT rate of 5%, 18% CT or admission and 19% only admission). Four patients with ciTBI were missed; none needed specific intervention. In the homogenous comparison cohort of 18,913 children, the SNC guideline performed similar to the PECARN CDR, when compared with the other CDRs.
conclusionThe SNC guideline showed a high accuracy in a large external validation cohort and compares well with published CDRs for the management of paediatric TBI.
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