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Advancing Prognostic Prediction in Pediatric Trauma: The Role of Inflammatory Markers
Abdulrahman Özel1, Servet Yuce2, Esra Nur Ilbegi3
1Pediatric İntensive Care Unit, Istanbul Bagcilar Training and Research Hospital, Istanbul, Turkey.
Insights
The Lactate-to-Albumin Ratio (LAR) and Procalcitonin (PCT) effectively predict mortality in pediatric trauma patients. These markers, along with others, can identify high-risk children in the PICU.
Area of Science:
- Pediatric Critical Care Medicine
- Trauma Surgery
- Inflammatory Biomarkers
Background:
- Pediatric trauma patients admitted to the PICU face significant mortality risks.
- Identifying reliable prognostic markers is crucial for timely intervention.
Purpose of the Study:
- To evaluate the prognostic value of inflammatory markers and complete blood count-derived indices in predicting mortality in pediatric trauma patients.
- To identify standalone and combined markers for risk stratification.
Main Methods:
- A retrospective study of 165 pediatric trauma patients in the PICU.
- Analysis of various inflammatory markers including Lactate-to-Albumin Ratio (LAR), Procalcitonin (PCT), Systemic Immune-Inflammation Index (SIRI), Neutrophil-to-Lymphocyte Ratio (NLR), CRP-to-Albumin Ratio (CAR), and Pan-Immune-Inflammation Value (PIV).
Main Results:
- The mortality rate was 5.45%.
- LAR (AUC 0.807) and PCT (AUC 0.745) showed strong prognostic performance for mortality.
- LAR and PCT correlated with mortality, mechanical ventilation duration, and PICU stay.
Conclusions:
- LAR and PCT are reliable standalone markers for predicting mortality in critically ill pediatric trauma patients.
- While other indices like SIRI, NLR, CAR, and PIV showed less individual effectiveness, they may have value in combination.
Background:
This study aimed to evaluate the prognostic value of various inflammatory markers and indices derived from complete blood counts in predicting mortality among pediatric trauma patients admitted to the Pediatric Intensive Care Unit (PICU).
Patients And Methods:
We designed a single-center retrospective study that included 165 pediatric trauma patients in the PICU between January 2020 and June 2024.
Results:
Of 165 patients, 108 (69.2%) were male and the mean age of all patients was 75.16±57.14 months. The mortality rate was found to be 5.45% (9 patients). The Lactate-to-Albumin Ratio (LAR) and Procalcitonin (PCT) demonstrated strong prognostic performance with area under the curve (AUCs) of 0.807 and 0.745, respectively. Notably, LAR and PCT correlated well with mortality and the duration of invasive mechanical ventilation and PICU stay. The Systemic Immune-Inflammation Index (SIRI), Neutrophil-to-Lymphocyte Ratio (NLR), CRP-to-Albumin Ratio (CAR), and Pan-Immune-Inflammation Value (PIV) were less effective individually but showed potential when combined with other indices.
Conclusion:
LAR, PCT, SIRI, NLR, CAR, and PIV were associated with mortality in pediatric trauma patients, with LAR and PCT demonstrating superior predictive value. Therefore, LAR and PCT may serve as reliable standalone markers for identifying critically ill pediatric trauma patients at risk of mortality.
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