External validation of pittsburgh infant brain injury score in a French pediatric study.

IF 1.3 4区医学 Q3 PEDIATRICS Archives De Pediatrie Pub Date : 2025-02-14 DOI:10.1016/j.arcped.2024.11.007

Cécile Oger, Audrey Grain, Elise Launay, Christèle Gras-Leguen, Fleur Lorton, Pauline Scherdel

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Abstract

Background: Abusive Head Trauma (AHT) is a leading cause of morbidity and mortality in infants requiring rapid neuroimaging performance and prognostic rapid diagnosis. The Pittsburgh Infant Brain Injury Score (PIBIS) clinical prediction rule (CPR) was derived to identify infants most likely to present brain injury, whose diagnosis would benefit from head CT. Our study aimed to externally validate the PIBIS CPR in a pediatric French population.

Methods: A retrospective study was conducted in a French pediatric emergency department between 2015 and 2017. We included all consecutive infants who underwent a neurological imaging. Medical data were collected, and PIBIS score was determined, both retrospectively.

Results: We included 129 infants among which 33 cases (including 20 with a diagnosis of AHT). The sensitivity and specificity of the PIBIS CPR were 75.8 % (95 % CI 57.7-88.9) and 61.4 % (51.0-71.2) and negative and positive predictive values 88.1 % (77.8-94.7) and 40.3 % (33.0-48.2). Among the 20 infants with a diagnosis of AHT, 19 (95.0 %) were correctly identified by the PIBIS CPR.

Conclusion: Our external validation study found a lower diagnostic value of the PIBIS CPR than in the original study. This argues for adding biomarkers to improve its performance, notably in the context of suspected AHT.

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背景：虐待性头部创伤（AHT）是导致婴儿发病和死亡的主要原因，需要快速的神经影像表现和预后快速诊断。匹兹堡婴儿脑损伤评分（PIBIS）临床预测规则（CPR）旨在识别最有可能出现脑损伤的婴儿，其诊断将受益于头部 CT。我们的研究旨在对法国儿科人群中的 PIBIS CPR 进行外部验证：一项回顾性研究于 2015 年至 2017 年在法国一家儿科急诊室进行。我们纳入了所有接受神经系统成像的连续婴儿。我们收集了医疗数据，并确定了PIBIS评分（均为回顾性评分）：我们纳入了 129 名婴儿，其中 33 例（包括 20 例诊断为 AHT）。PIBIS CPR 的敏感性和特异性分别为 75.8 %（95 % CI 57.7-88.9）和 61.4 %（51.0-71.2），阴性和阳性预测值分别为 88.1 %（77.8-94.7）和 40.3 %（33.0-48.2）。在诊断为 AHT 的 20 名婴儿中，19 名（95.0%）被 PIBIS CPR 正确识别：我们的外部验证研究发现，PIBIS CPR 的诊断价值低于原始研究。结论：我们的外部验证研究发现，PIBIS CPR 的诊断价值低于原始研究，因此需要增加生物标志物来提高其性能，尤其是在怀疑 AHT 的情况下。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Archives De Pediatrie 医学-小儿科

CiteScore

2.80

自引率

5.60%

发文量

106

审稿时长

24.1 weeks

期刊介绍： Archives de Pédiatrie publishes in English original Research papers, Review articles, Short communications, Practice guidelines, Editorials and Letters in all fields relevant to pediatrics. Eight issues of Archives de Pédiatrie are released annually, as well as supplementary and special editions to complete these regular issues. All manuscripts submitted to the journal are subjected to peer review by international experts, and must: Be written in excellent English, clear and easy to understand, precise and concise; Bring new, interesting, valid information - and improve clinical care or guide future research; Be solely the work of the author(s) stated; Not have been previously published elsewhere and not be under consideration by another journal; Be in accordance with the journal''s Guide for Authors'' instructions: manuscripts that fail to comply with these rules may be returned to the authors without being reviewed. Under no circumstances does the journal guarantee publication before the editorial board makes its final decision. Archives de Pédiatrie is the official publication of the French Society of Pediatrics.