Related Experiment Videos
The prognostic importance of trauma scoring systems in pediatric patients
Adnan Narci1, Okan Solak, Nurten Turhan-Haktanir
1Department of Pediatric Surgery, School of Medicine, Afyon Kocatepe University, Cocuk Cerrahisi AD, 03200, Afyon, Turkey. adnannarci@yahoo.com
Insights
The Injury Severity Score (ISS) effectively predicts outcomes in pediatric trauma patients. Easily accessible lab tests like blood glucose, AST, and ALT also offer valuable prognostic insights.
Area of Science:
- Pediatric Traumatology
- Emergency Medicine
- Clinical Scoring Systems
Background:
- Traumatic injuries are a leading cause of death and disability in children.
- Evaluating pediatric trauma patients requires accurate prognostic tools to guide management.
- General trauma scores aim to standardize the assessment of injury severity and predict patient outcomes.
Purpose of the Study:
- To assess the predictive capabilities of various general trauma scoring systems for mortality and morbidity in pediatric patients.
- To identify key factors influencing outcomes in pediatric trauma cases.
Main Methods:
- Retrospective analysis of 74 pediatric trauma patients admitted between 2006 and 2008.
- Data collected included demographics, trauma characteristics, time to hospital, vital signs, laboratory results, and hospital outcomes.
- Calculation and evaluation of multiple trauma scores: Glasgow Coma Scale (GCS), Abbreviated Injury Scale (AIS), Trauma Score-Injury Severity Score (TRISS), Revised Trauma Score (RTS), Injury Severity Score (ISS), and Pediatric Trauma Score (PTS).
Main Results:
- The study included 74 patients (50% male, mean age 7.0 years), with blunt trauma being the most common (89.2%).
- Morbidity rate was 60.8% and mortality rate was 2.7%.
- Abbreviated Injury Scale (AIS), Injury Severity Score (ISS), Trauma Score-Injury Severity Score (TRISS), and Pediatric Trauma Score (PTS) were significant predictors of morbidity. AIS and ISS predicted hospital stay length, while RTS, TRISS, ISS, and PTS predicted ICU admission. Blood glucose, AST, and ALT predicted liver trauma.
Conclusions:
- The Injury Severity Score (ISS) demonstrated superior prognostic value compared to other scoring systems for pediatric trauma patients.
- Readily available laboratory markers including blood glucose, AST, and ALT serve as cost-effective and valuable tools for prognostic evaluation in pediatric trauma.
Purpose:
Traumas are among important causes of morbidity and mortality in the pediatric group. Our aim was to evaluate the predicting effects of general trauma scores on mortality and morbidity rates.
Methods:
The files of 74 patients, who were admitted to our hospital with trauma between the years 2006 and 2008, were retrospectively investigated. Patients' ages, sex, types of trauma, the time between the trauma and entrance to the hospital, vital and laboratory findings, length of hospital stay, length of intensive care unit (ICU) stay, surgical interventions, the organs affected by the trauma, morbidity, and mortality rates were recorded., glasgow coma scale (GCS), abbreviated injury scale (AIS), trauma score-injury severity score (TRISS), revised trauma score (RTS), injury severity score (ISS), pediatric trauma score (PTS), specific trauma scores for lung, liver, and spleen were calculated using the data in the files.
Results:
The mean age of patients was 7.0+/-4.34 (1-16) years and 50% of them were men. The types of the trauma were blunt in 66 (89.2%) patients, penetrating in 5 (6.8%) patients and injury due to gun shot in 3 (4.1%) patients. The mean time between the trauma and entrance to the emergency service was 80.40+/-36.67 (10-120) min. Emergency operation and elective surgery was performed in 13 (17%) and 20 (27%) patients, respectively. The mean length of hospitalization was 4.50+/-7.93 (1-35) days.Seven (9.5%) patients needed ICU. The morbidity and mortality rates were 60.8% (n=45) and 2.7% (n=2), respectively. AIS, ISS, TRISS and PTS were independent predictors of morbidity (p<0.05). AIS and ISS were independent predictors of the length of hospital stay (p<0.05). RTS, TRISS, ISS and PTS were independent predictors of the need for ICU (p<0.05). Among laboratory findings, blood glucose, AST and ALT were found to be independent predictors of liver trauma.
Conclusion:
ISS was found to be more valuable than other trauma scoring systems for prognostic evaluation of pediatric trauma patients. On the other hand, blood glucose, AST, and ALT are easily available, cheap, and valuable alternative laboratory findings in prognostic evaluation.
