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The value of prognostic markers for pediatric trauma patients
Cansu Durak1, Ebru Guney Sahin1, Yasar Yusuf Can1
1Department of Pediatric Intensive Care, Sancaktepe Sehit Prof. Dr. IlhanVarank Training and Research Hospital, Health Science University, Istanbul 34785, Türkiye.
Insights
Pediatric trauma patients admitted to the PICU have limited follow-up data. Baseline procalcitonin (PCT), lactate/albumin ratio (LAR), and neutrophil/lymphocyte ratio (NLR) can predict mortality risk in these critically ill children.
Area of Science:
- Pediatric Intensive Care Medicine
- Trauma Care
- Critical Care Medicine
Background:
- Limited data exists on the follow-up of pediatric trauma patients in pediatric intensive care units (PICUs).
- This study evaluates the experience with trauma patients admitted to a specific PICU.
Purpose of the Study:
- To assess the outcomes and identify predictors of mortality in pediatric trauma patients.
- To evaluate the performance of various clinical and laboratory markers in predicting mortality.
Main Methods:
- Retrospective analysis of 77 pediatric trauma patients admitted to the PICU between August 2020 and December 2022.
- Data collected included demographics, clinical parameters, and laboratory results.
- Mortality was the primary outcome, with receiver operating characteristic (ROC) curves used to evaluate predictive markers.
Main Results:
- The mortality rate was 11.1% (9 out of 77 patients).
- Non-survivors had significantly higher Pediatric Risk of Mortality III (PRISM III) scores, inotrope, extracorporeal treatment, and mechanical ventilator requirements.
- Laboratory markers such as procalcitonin (PCT), lactate/albumin ratio (LAR), neutrophil/lymphocyte ratio (NLR), and transfusion requirements were also significantly higher in non-survivors.
Conclusions:
- Baseline procalcitonin (PCT), lactate/albumin ratio (LAR), and neutrophil/lymphocyte ratio (NLR) are valuable indicators for identifying pediatric trauma patients at risk of mortality.
- These markers can aid in early risk stratification and management decisions in the PICU.
Background:
Despite the rapid development of pediatric intensive care medicine, there are still limited data in the literature regarding the follow-up of pediatric trauma patients in pediatric intensive care units (PICUs). In this study, we aim to evaluate our experience with children admitted and followed up with the diagnosis of trauma at our PICU.
Methods:
We evaluated the retrospective data of 77 pediatric trauma patients who were admitted to the PICU at Sancaktepe Sehit Prof. Dr. IlhanVarank Training and Research Hospital from August 2020 to December 2022. The demographic data, clinical parameters and laboratory results were recorded. The primary outcome was the mortality in PICU. The performances of markers in predicting mortality were evaluated with receiver operating characteristic (ROC) curves.
Results:
The median age of the patients was 70 (33-157) months, and the median duration of hospitalization in the PICU was 6 (2-11) d. Of the 77 patients, 9 died due to trauma (11,1%). Among the clinical parameters, Pediatric Risk of Mortality III (PRISM III) Score, inotrope requirement, extracorporeal treatment requirement, and mechanical ventilator requirement were significantly higher in non-survivors than in survivors. Among the laboratory parameters, procalcitonin (PCT), lactate/albumin ratio (LAR), neutrophil/lymphocyte ratio (NLR), and transfusion requirement were significantly higher in non-survivors than in survivors.
Conclusion:
In pediatric trauma patients, baseline PCT, LAR, and NLR values can be used to identify patients at risk for mortality.
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