Evaluation of the Pediatric Trauma Score
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C R Kaufmann1, R V Maier, F P Rivara
1Department of Surgery, University of Washington, Seattle.
Insights
The Pediatric Trauma Score (PTS) shows no advantage over the Revised Trauma Score for pediatric trauma triage. The Revised Trauma Score offers superior accuracy and universal applicability in assessing injured children.
Area of Science:
- Pediatric Emergency Medicine
- Trauma Surgery
- Clinical Triage Tools
Background:
- The Pediatric Trauma Score (PTS) is a new triage tool for children.
- Its utility requires comparison with existing scores like the Revised Trauma Score (RTS).
Purpose of the Study:
- To compare the effectiveness of the PTS versus the RTS in pediatric trauma triage.
- To evaluate the accuracy and utility of both scoring systems.
Main Methods:
- Retrospective chart review of 376 children (0-14 years) admitted to a level 1 trauma center.
- Analysis of correlations between PTS, RTS, and clinical outcomes (survival, Injury Severity Score, APACHE II, GCS, etc.).
Main Results:
- Both PTS and RTS correlated significantly with survival, injury severity, and resource utilization.
- RTS demonstrated higher triage accuracy (78.8%) compared to PTS (68.3%).
- PTS offered no statistical advantage over RTS.
Conclusions:
- The RTS is a universally applicable and accurate tool for pediatric trauma triage.
- The PTS does not provide additional benefits and requires learning a separate system.
Abstract:
A Pediatric Trauma Score (PTS) was recently developed and is rapidly gaining acceptance as a triage tool. This study examines the utility of the PTS as compared with the Revised Trauma Score, which is applicable to all ages. The charts of 376 children 0 to 14 years of age who were admitted to the trauma service of a level 1 trauma center were reviewed. Significant correlations were found for both the PTS and the Revised Trauma Score with survival, the Injury Severity Score, APACHE II score, vital signs, the Glasgow Coma Scale score, hematocrit, need for an operation, and number of days in an intensive care unit. The PTS was of no statistical advantage as compared with the Revised Trauma Score. Triage accuracy was 68.3% for the PTS and 78.8% for the Revised Trauma Score. The Revised Trauma Score is easy to use and universal in its applicability. The PTS involves learning a separate scoring system and is of no advantage.