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A nomogram for predicting hemorrhagic shock in pediatric patients with multiple trauma
Nan Lin1, Jingyi Jin1, Sisi Yang1
1Department of Neonatal Surgery, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, 310052, China.
Scientific Reports
|June 10, 2024
Summary
This study developed a nomogram to predict hemorrhagic shock in pediatric trauma patients. The tool uses key indicators for early identification and improved clinical management of children with multiple injuries.
Area of Science:
- Pediatric Emergency Medicine
- Trauma Surgery
- Clinical Prediction Modeling
Background:
- Hemorrhagic shock in pediatric trauma requires timely detection and management.
- Existing methods may lack accuracy or efficiency for early identification in this population.
Purpose of the Study:
- To develop and validate a nomogram for predicting hemorrhagic shock in pediatric patients with multiple trauma.
- To provide a tool for early identification and facilitate timely clinical intervention.
Main Methods:
- Retrospective study of 325 pediatric trauma patients, with external validation on 144 patients.
- Least Absolute Shrinkage and Selection Operator (LASSO) regression for predictor selection.
- Multivariable logistic regression and nomogram construction, validated with C-index, ROC, calibration, and DCA.
Main Results:
- Systolic blood pressure (ΔSBP), platelet count, activated partial thromboplastin time (APTT), and injury severity score (ISS) were identified as independent predictors.
- The nomogram achieved a high area under the curve (AUC) of 0.963, indicating robust predictive performance.
- The model demonstrated good calibration and improved clinical utility via decision curve analysis, confirmed by external validation.
Conclusions:
- A reliable nomogram for predicting hemorrhagic shock in pediatric multiple trauma patients has been successfully developed.
- This tool can aid clinicians in the timely and effective management of pediatric trauma patients at risk of hemorrhagic shock.
