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Pediatric Age-adjusted Shock Index (SIPA): From Injury to Outcome in Blunt Abdominal Trauma
Meghna Kinjalk1, Nitin Jain1, Sujoy Neogi1
1Department of Pediatric Surgery, Maulana Azad Medical College, New Delhi, India.
Insights
An elevated Shock Index Pediatric Age-Adjusted (SIPA) score in pediatric trauma patients is linked to increased blood transfusions and longer hospital stays. This score may help identify patients with poor outcomes, including those needing emergency surgery.
Area of Science:
- Pediatric Trauma Care
- Clinical Triage Tools
- Emergency Medicine
Background:
- The Shock Index Pediatric Age-Adjusted (SIPA) score aids in identifying pediatric trauma patients at risk of adverse outcomes.
- Effective triage is crucial for managing pediatric trauma patients.
Purpose of the Study:
- To investigate the association between elevated SIPA scores and specific outcomes in pediatric trauma patients.
- To evaluate the predictive value of SIPA scores for patient outcomes.
Main Methods:
- A retrospective study analyzed 58 pediatric blunt abdominal trauma cases.
- Patients were categorized by normal or elevated SIPA scores at presentation.
- Outcomes included blood transfusion, interventions, surgery, CT scans, ventilation, ICU stay, hospital stay, and mortality.
Main Results:
- Elevated SIPA scores were observed in 46% of patients.
- A significant correlation was found between elevated SIPA scores and the need for blood transfusion (68.75%) and extended hospital stay (10.48 ± 7.54 days).
- No statistically significant relationship was found between elevated SIPA and emergency surgery, CT scan, or ICU stay.
Conclusions:
- Elevated SIPA scores at presentation significantly correlate with the need for blood transfusion and longer hospital stays in pediatric trauma.
- While not statistically significant, elevated SIPA was associated with emergency surgery and CT scan requirements in over half of cases.
- SIPA score assessment can aid in identifying pediatric trauma patients likely to experience adverse outcomes.
Purpose:
The Shock Index Pediatric Age-Adjusted (SIPA) score is a useful tool for identifying pediatric trauma patients at a risk of poor outcomes and for triaging. We are studying the relationship between elevated SIPA score and specific outcomes in pediatric trauma patients.
Materials And Methods:
A retrospective study was conducted in which case records of 58 pediatric patients with blunt abdominal trauma were evaluated and tabulated for their SIPA scores only at the time of their initial presentation and categorized into two groups - normal SIPA and elevated SIPA. The primary outcomes were need for blood transfusion, need for any intervention, and need for emergency surgery, and the secondary outcomes were need for computed tomography (CT) scan, need for a ventilator, intensive care unit (ICU) stay, length of hospital stay, and mortality. Statistical methods were applied to find a relationship between elevated SIPA score and the primary and secondary outcomes.
Results:
An elevated SIPA score was noted in 27 (46%) patients. There was a significant relationship between elevated SIPA scores and patients needing blood transfusion (68.75%, n = 11) and length of hospital stay (10.48 ± 7.54 days). A significant relationship between elevated SIPA score and need for emergency surgery (54.54%, n = 6), need for a CT scan (56%, n = 14), and ICU stay (50%, n = 2) was not found.
Conclusion:
We have seen in our study that elevated SIPA scores at presentation are significantly related to need for blood transfusion and length of hospital stay. In more than half of the patients, elevated SIPA was associated with need for emergency surgery and requirement of CT scan, but it was statistically not significant. Therefore, assessment of this parameter can help in identifying such poor outcomes.
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