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Outcome analysis of blunt injury in children
M R Eichelberger1, E A Mangubat, W J Sacco
1Department of Surgery, George Washington University Medical School, Washington, D.C.
Insights
The Trauma and Injury Severity Score (TRISS) accurately predicts outcomes for pediatric blunt trauma patients, showing no significant difference compared to adult trauma data. This tool is useful for assessing injury severity in children.
Area of Science:
- Pediatric Trauma Research
- Injury Epidemiology
- Clinical Outcomes Analysis
Background:
- Pediatric trauma outcomes require validated assessment tools.
- Comparing pediatric and adult trauma data is crucial for resource allocation and treatment protocols.
- The Trauma and Injury Severity Score (TRISS) is a standard tool for adult trauma outcome prediction.
Purpose of the Study:
- To evaluate the utility of the TRISS methodology in predicting outcomes for pediatric blunt trauma patients.
- To compare the predicted outcomes of pediatric trauma patients with the established adult norm population.
- To define injury severity parameters specific to pediatric blunt trauma.
Main Methods:
- Analysis of 1,009 pediatric patients (<15 years) admitted to a Pediatric Trauma Center.
- Application of the TRISS methodology to four distinct pediatric age groups (0-1, 0-3, 0-8, 0-14 years).
- Comparison of TRISS-predicted outcomes against the adult MTOS norm population.
Main Results:
- TRISS analysis showed no statistically significant difference in predicted survival outcomes between pediatric age groups and the adult baseline.
- A low misclassification rate (0.69%) for survival/death outcomes was observed in pediatric patients.
- TRISS effectively characterized the injury severity mix within the pediatric cohort.
- A Threshold Score (TS) ≤ 14 and Injury Severity Score (ISS) > 15 were identified as useful indicators of severity in pediatric blunt trauma.
Conclusions:
- TRISS is a reliable tool for predicting outcomes in pediatric blunt trauma.
- The TRISS methodology can be effectively applied to pediatric populations, demonstrating comparability with adult data.
- Specific injury severity parameters (TS ≤ 14, ISS > 15) can aid in defining severity for injured children.
Abstract:
A group of 1,009 children less than 15 years of age and consecutively admitted to a Pediatric Trauma Center was used to compare outcomes with the adult (15-54 yrs) MTOS norm population using TRISS. Four pediatric age groups (0-1, 0-3, 0-8, 0-14 yrs) formed the study groups. TRISS analysis resulted in no statistically significant difference in predicted outcome between any of the four pediatric groups and the adult baseline group. There were only seven misclassified children (0.69%) with respect to survival/death outcome, indicating the usefulness of TRISS to characterize pediatric blunt trauma. In addition, TRISS was used to delineate the injury severity mix of the pediatric population. A TS less than or equal to 14 and ISS greater than 15 was found to serve as a useful definition of severity in this group of injured children.