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Comparison of the BIG Score and Pediatric Trauma Score for Predicting Mortality
Adem Az1, Yunus Dogan2, Ozgur Sogut1
1From the Department of Emergency Medicine, University of Health Sciences, Haseki Research and Training Hospital, Istanbul, Türkiye.
Insights
The BIG score and Pediatric Trauma Score (PTS) effectively predict mortality in pediatric trauma patients. The BIG score offers higher specificity and positive predictive value, while PTS demonstrates superior negative predictive value.
Area of Science:
- Pediatric Emergency Medicine
- Trauma Surgery
- Clinical Scoring Systems
Background:
- Predicting mortality in pediatric patients with multiple trauma is crucial for effective clinical management.
- Existing scoring systems require evaluation for their efficacy in diverse trauma populations.
Purpose of the Study:
- To compare the predictive accuracy of the BIG score against the Pediatric Trauma Score (PTS) for mortality in pediatric multiple trauma patients.
Main Methods:
- A retrospective, single-center study analyzed 318 pediatric patients (aged 1-18) with multiple trauma.
- Demographic and clinical data, including BIG score and PTS, were compared between survivors and non-survivors.
Main Results:
- The BIG score cutoff of 13.7 showed 92.86% sensitivity and 95.52% specificity (AUC 0.98).
- A PTS of 7 demonstrated 100% sensitivity and 81.03% specificity (AUC 0.97).
- The BIG score had a higher positive predictive value (66.7%) compared to PTS (33.7%).
Conclusions:
- Both BIG score and PTS are robust predictors of mortality in pediatric multiple trauma.
- The BIG score exhibited superior specificity and positive predictive value.
- A PTS of 7 provided 100% sensitivity and a higher negative predictive value.
Objectives:
The BIG score (base deficit + [2.5 × international normalized ratio] + [15 - Glasgow Coma Score]) was compared with the Pediatric Trauma Score (PTS) for predicting mortality in pediatric patients with multiple trauma.
Methods:
This retrospective, single-center study included 318 consecutive pediatric patients (aged 1-18 years) with multiple trauma who were admitted to the emergency department between January 1, 2021, and December 31, 2023. The demographic characteristics, clinical characteristics, and trauma scores (BIG score and PTS) were compared between survivors and nonsurvivors to identify factors associated with mortality.
Results:
A PTS of 7 had 100% sensitivity and 81.03% specificity for predicting mortality, with an area under the curve of 0.97 (95% confidence interval 0.9-0.99). Although the positive predictive value (PPV) was low (33.7%), the negative predictive value (NPV) was 100%. A BIG score of 13.7 was identified as the cutoff for mortality, with 92.86% sensitivity and 95.52% specificity (area under the curve 0.98, 95% confidence interval 0.96-0.99). The PPV was 66.7% and the NPV was 99.3%.
Conclusions:
Both the PTS and the BIG score were strong predictors of mortality in pediatric patients with multiple trauma. The BIG score had a higher specificity and PPV, whereas a PTS of 7 had 100% sensitivity and a higher NPV.
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