Related Experiment Video
Updated: Jul 24, 2026
Description of a Swine Infant Model of Volume-Controlled Hemorrhagic Shock
Published on: November 3, 2023
Comparative Evaluation of Shock Index Pediatric Age Adjusted and Pediatric Trauma Score in Predicting Morbidity in
Harsh Bhomaj1, Simmi K Ratan1, Tanvi Luthra1
1Department of Pediatric Surgery, Maulana Azad Medical College, New Delhi, India.
Insights
The pediatric trauma score (PTS) and age-adjusted shock index (SIPA) both predict outcomes in pediatric abdominal trauma. PTS is more consistent for delayed presentations, while SIPA is useful for immediate triage.
Area of Science:
- Pediatric Emergency Medicine
- Trauma Surgery
- Clinical Triage
Background:
- Accurate prediction of outcomes in pediatric trauma patients is crucial for effective management.
- Existing scoring systems require evaluation for specific injury patterns like abdominal trauma.
Purpose of the Study:
- To compare the predictive accuracy of the pediatric trauma score (PTS) and the shock index pediatric age adjusted (SIPA) score in children with abdominal trauma.
- To determine the utility of these scores at different time points post-injury.
Main Methods:
- A prospective study involving pediatric trauma patients with abdominal injuries over 18 months.
- SIPA and PTS scores were calculated upon admission and 24 hours later.
- Outcomes were assessed using a morbidity scoring system and compared with score predictions.
Main Results:
- Both SIPA and PTS correlated significantly with morbidity, showing 82% predictive accuracy at admission.
- SIPA normalized in 70% of cases by 24 hours, while PTS remained consistent.
- Pneumoperitoneum, low PTS, and infant age were independently associated with poor outcomes.
Conclusions:
- SIPA is valuable for immediate triage of pediatric abdominal trauma.
- PTS demonstrates better consistency for delayed assessment and may require age-based adjustments for optimal use.
Aim:
This study aims to compare the pediatric trauma score (PTS) and shock index pediatric age adjusted (SIPA) score for predicting the outcome in children presenting with trauma mainly abdomen.
Methodology:
Prospective study of 18 months with recruitment of trauma patients admitted to a tertiary centre with mainly abdominal trauma. After immediate resuscitation, SIPA and PTS scores were computed and reassessed 24 h later. The outcomes of injured subjects were analyzed using an indigenous morbidity scoring system and compared with SIPA and PTS scores. Statistical methods were used for demographic details, uni/multivariate analysis, and for calculating predictive values.
Results:
Male (aged 5-8 years) was identified as most commonly injured. Fall was noted as most frequent mechanism and maximally contributed to high morbidity. Liver was most frequently injured, whereas hollow viscous injuries (pneumoperitoneum) were associated with the poorest outcome. SIPA and PTS, both at admission and 24 h later, significantly correlated with morbidity, with 82% predictive accuracy (P < 0.001 for SIPA; P = 0.003 for PTS). This association weakened at 24 h with normalization of SIPA after resuscitation in 70% of cases, whereas PTS maintained uniformity with consistency across 24 h. Multivariate regression analysis identified that among significant factors, pneumoperitoneum, low PTS, and infant subjects had the highest odds ratios for poor outcome following trauma to the abdomen.
Conclusion:
Pediatric trauma victims with abdominal injuries can be triaged using SIPA soon after injury, whereas for delayed presenters, PTS is a better alternative, albeit with suggested age-based value correction for its components.
