Pediatric trauma BIG score: Predicting mortality in polytraumatized pediatric patients

Area of Science:

• Pediatric Emergency Medicine
• Trauma Surgery
• Clinical Scoring Systems

Background:

• Trauma remains a leading cause of death and disability globally, especially in pediatric populations.
• Advances in pediatric trauma care have improved outcomes for injured children.
• Accurate injury severity assessment is crucial for effective trauma management.

Purpose of the Study:

• To evaluate the pediatric BIG score's efficacy in predicting mortality.
• To compare the pediatric BIG score against the New Injury Severity Score (NISS) and Pediatric Trauma Score (PTS).
• To assess the utility of these scores in a Tanta University Emergency Hospital setting.

Main Methods:

• A prospective study involving multiple trauma pediatric patients admitted to the Emergency Department over one year.
• Calculation of pediatric BIG score, NISS, and PTS for all eligible patients.
• Comparison of score performance against observed mortality rates.

Main Results:

• The pediatric BIG score demonstrated higher sensitivity (86.7%) and specificity (71.4%) for mortality prediction compared to PTS and NISS.
• A significant positive correlation was observed between higher BIG scores and increased mortality rates.
• PTS and NISS showed lower sensitivity and specificity in predicting pediatric trauma mortality.

Conclusions:

• The pediatric BIG score is a reliable and readily applicable tool for mortality prediction in pediatric trauma.
• Its components (INR, BE, GCS) are rapidly measurable in emergency settings.
• The score's application may be limited in pediatric patients with chronic conditions affecting INR, BE, or GCS.