Orvosi hetilap · 2026
[Pediatric head injury: evaluation of the new institutional protocol].
СтатьяНаблюдательное исследованиеАннотация на английскомНазвание и аннотация: Перевод в очереди
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Fadgyas Balázs, Altorjai Péter, Őri Dorottya, Bognár Zsolt, Ringwald Zoltán
Аннотация
INTRODUCTION: In Hungary, minor head injuries in children are treated by representatives of several professions according to local practice. Skull X-rays were often routinely performed, in contrast to international practice.
OBJECTIVE: To examine the previous and the current institutional minor head injury care protocol introduced in 2020.
METHOD: A retrospective, observational cohort study was conducted between 2018 and 2022 at the Heim Pál National Institute of Pediatrics. Before 2020, all children with head injuries were treated at the pediatric trauma outpatient clinic, and a skull X-ray was routinely performed. The protocol introduced in 2020 no longer required this for minor head injuries. Patients were divided into two groups: group A for those treated in 2018-2019 and group B for those treated in 2021-2022. Inclusion criteria were age 0-18 years, isolated, mild head injury. The number of X-ray examinations performed, outpatients or patients admitted to the ward were registered. The chi-square test was used for statistical analysis.
RESULTS: 17.92% (n = 1886) of children in group A were admitted to the ward, while 34.11% (n = 2353) in group B were admitted (p<0.0001). 10 520 patients in group A were treated for mild head injury, while 6898 patients in group B were treated. The number of X-rays performed in connection with all head injuries decreased in group B (1644/6898, 23.83%) compared to group A (9324/10 520, 88.63%) (p<0.0001).
DISCUSSION: The new protocol emphasizes observation and physical examination and does not recommend routine skull X-rays. Most patients with mild head injuries are now treated in the Emergency Department, while those with more severe symptoms or co-injuries are treated in the Traumatology Department.
CONCLUSION: After the introduction of the new protocol, more patients were admitted, but for shorter periods of observation than before (6-24 hours instead of 48). Orv Hetil. 2026; 167(23): 916-922.
OBJECTIVE: To examine the previous and the current institutional minor head injury care protocol introduced in 2020.
METHOD: A retrospective, observational cohort study was conducted between 2018 and 2022 at the Heim Pál National Institute of Pediatrics. Before 2020, all children with head injuries were treated at the pediatric trauma outpatient clinic, and a skull X-ray was routinely performed. The protocol introduced in 2020 no longer required this for minor head injuries. Patients were divided into two groups: group A for those treated in 2018-2019 and group B for those treated in 2021-2022. Inclusion criteria were age 0-18 years, isolated, mild head injury. The number of X-ray examinations performed, outpatients or patients admitted to the ward were registered. The chi-square test was used for statistical analysis.
RESULTS: 17.92% (n = 1886) of children in group A were admitted to the ward, while 34.11% (n = 2353) in group B were admitted (p<0.0001). 10 520 patients in group A were treated for mild head injury, while 6898 patients in group B were treated. The number of X-rays performed in connection with all head injuries decreased in group B (1644/6898, 23.83%) compared to group A (9324/10 520, 88.63%) (p<0.0001).
DISCUSSION: The new protocol emphasizes observation and physical examination and does not recommend routine skull X-rays. Most patients with mild head injuries are now treated in the Emergency Department, while those with more severe symptoms or co-injuries are treated in the Traumatology Department.
CONCLUSION: After the introduction of the new protocol, more patients were admitted, but for shorter periods of observation than before (6-24 hours instead of 48). Orv Hetil. 2026; 167(23): 916-922.