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Diagnostic value of CT scans in pediatric patients with acute non-traumatic altered mental status: a systematic review and meta-analysis
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Diagnostic value of CT scans in pediatric patients with acute non-traumatic altered mental status: a systematic review and meta-analysis

Mohammed Alsabri, Mohammed Ayyad, Mayar M Aziz, Mohamed Sayed Zaazouee, Alaa Ahmed Elshanbary, Muhammad Ashir Shafique, Lamar Sarieddine, Ibrahim Qattea, Muhammad Waseem and Luis L Gamboa
European journal of pediatrics, v 184(2), p136
15 Jan 2025
DOI: https://doi.org/10.1007/s00431-024-05943-3
PMID: 39812876
Featured in Collection :   Research Supported by Drexel Libraries' OA Programs
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https://doi.org/10.1007/s00431-024-05943-3View
Published, Version of Record (VoR)Open Access via Drexel Libraries Read and Publish Program 2024CC BY V4.0,  Open

Abstract

Acute Disease Adolescent Child Child, Preschool Consciousness Disorders - diagnostic imaging Consciousness Disorders - etiology Humans Radiation Exposure - adverse effects Tomography, X-Ray Computed - methods Tomography, X-Ray Computed - statistics & numerical data
Computed tomography (CT) scans are widely used for evaluating children with acute atraumatic altered mental status (AMS) despite concerns about radiation exposure and limited diagnostic yield. This study aims to assess the efficacy of CT scans in this population and provide evidence-based recommendations. A systematic review was conducted according to PRISMA guidelines. Comprehensive searches were performed in PubMed, Embase, Cochrane Library, Scopus, and Web of Science for studies involving pediatric patients with acute atraumatic AMS undergoing head CT scans. Two independent reviewers conducted the literature search, extracted data, and assessed study quality. From 4,739 identified studies, 13 met the inclusion criteria. The overall positive diagnostic yield of head CT scans was 35.9% (95% CI: 6.1%-65.7%). Subgroup analyses revealed that the diagnostic yield varied by clinical setting, age group, and presenting symptoms. Head CT scans are frequently performed in pediatric patients with AMS, but their diagnostic usefulness is limited. Evidence-based guidelines and risk stratification methods are necessary to improve imaging utilization and minimize radiation exposure risks. What is Known • Computed tomography (CT) scans are commonly used to evaluate pediatric patients with acute atraumatic altered mental status (AMS). • There are concerns about radiation exposure from CT scans, especially in children due to their increased sensitivity and longer life expectancy. • Previous studies suggest a low diagnostic yield of CT scans in certain pediatric conditions, indicating potential overuse. What is New • This systematic review and meta-analysis specifically assess the diagnostic value of CT scans in pediatric patients with acute atraumatic AMS. • Findings reveal a relatively low positive diagnostic yield, indicating that CT scans may be overutilized in this population. • Subgroup analyses highlight variability in outcomes based on clinical setting, patient age, and presenting symptoms. • The study underscores the need for evidence-based guidelines and risk stratification tools to optimize imaging decisions and reduce unnecessary radiation exposure in children.

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Pediatrics
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