pecarn_c_spine_rule: PECARN Pediatric Cervical Spine Injury Risk Score

In cliot: Clinical Indices and Outcomes Tools

PECARN Pediatric Cervical Spine Injury Risk Score

Description

Applies the PECARN decision rule to identify children at very low risk of clinically important cervical spine injury (CSI) after blunt trauma. The rule stratifies patients into High Risk (requiring CT), Intermediate Risk (requiring plain films or observation), and Low Risk (no imaging needed).

Usage

pecarn_c_spine_rule(gcs_score, altered_mental_status, focal_neurologic_deficit,
                    neck_pain, torticollis, substantial_torso_injury,
                    predisposing_condition, high_risk_mechanism)

Arguments

gcs_score	Numeric. Glasgow Coma Scale score (3-15). (GCS < 15 is a high-risk factor).
altered_mental_status	Numeric (0 or 1). Presence of altered mental status (agitation, somnolence, repetitive questioning, or slow response to verbal questioning). (1 = Yes).
focal_neurologic_deficit	Numeric (0 or 1). Presence of focal neurologic deficit. (1 = Yes).
neck_pain	Numeric (0 or 1). Patient complains of neck pain. (1 = Yes).
torticollis	Numeric (0 or 1). Presence of torticollis (wry neck/stiff neck). (1 = Yes).
substantial_torso_injury	Numeric (0 or 1). Presence of substantial torso injury (e.g., seatbelt sign, chest/abdominal tenderness, or deformities). (1 = Yes).
predisposing_condition	Numeric (0 or 1). Presence of conditions predisposing to CSI (e.g., Trisomy 21, collagen vascular disease, prior cervical spine surgery/abnormality). (1 = Yes).
high_risk_mechanism	Numeric (0 or 1). High-risk mechanism of injury (e.g., diving, MVC, fall > 10ft/3m, axial load). (1 = Yes).

Value

A list containing:

Risk_Level	Classification (High Risk, Intermediate Risk, Low Risk).
Recommendation	Imaging guidance based on the risk level.

References

Leonard JC, Kuppermann N, Olsen C, et al. Factors associated with cervical spine injury in children after blunt trauma. Ann Emerg Med. 2011;58(2):145-155. doi:10.1016/j.annemergmed.2010.08.038

Examples

# Example 1: High Risk (GCS 14)
pecarn_c_spine_rule(14, 0, 0, 0, 0, 0, 0, 1)

# Example 2: Intermediate Risk (Neck Pain only)
pecarn_c_spine_rule(15, 0, 0, 1, 0, 0, 0, 0)

# Example 3: Low Risk (No factors)
pecarn_c_spine_rule(15, 0, 0, 0, 0, 0, 0, 0)

cliot documentation built on Dec. 1, 2025, 1:06 a.m.