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Development and validation of a pediatric model predicting trauma-related mortality.
Mary Evans1, Karthik Rajasekaran2, Anish Murala3
1McGovern Medical School, 6431 Fannin St, Houston, TX, 77030, USA.
BMC Pediatrics
|December 19, 2023
Summary
A new TRAGIC+ Model predicts mortality in pediatric trauma patients with 96.4% accuracy. This tool uses easily obtainable variables for clinical use, outperforming existing scores.
Area of Science:
- Pediatric Trauma Research
- Clinical Prediction Modeling
- Public Health Surveillance
Background:
- Pediatric trauma is a significant cause of mortality.
- Accurate prediction of mortality is crucial for timely intervention.
- Existing models may lack precision or ease of clinical application.
Purpose of the Study:
- To develop a novel prediction model for mortality in pediatric trauma injuries.
- To create a translational tool for practical clinical use in emergency settings.
Main Methods:
- Retrospective cohort study using the National Trauma Data Bank (2007-2015).
- Identified clinical and physiological predictors of pediatric death.
- Model development (80% cohort) and validation (20% cohort and temporal cohort).
- Assessed model performance using the area under the receiver operating characteristic curve (AUC).
Main Results:
- Analyzed 693,192 pediatric trauma cases with a 1.4% mortality rate.
- The TRAGIC+ Model achieved an AUC of 96.4%.
- TRAGIC+ Model outperformed the Injury Severity Score (AUC 92.9%) and Revised Trauma Score (AUC 95.0%).
Conclusions:
- The TRAGIC+ Model is a highly accurate new tool for predicting pediatric trauma mortality.
- It utilizes readily available variables at admission, facilitating clinical integration.
- This model offers improved predictive performance compared to established trauma scores.
