Predictive Accuracy of Paediatric Trauma Score, our experience at Children Hospital, Lahore (original) (raw)
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2020
In this study, we aimed to investigate the effectiveness of trauma scoring systems for predicting the sepsis and multiple organ failure in pediatric trauma patients. A total of 330 trauma patients with 112 children and 218 adults admitted to the emergency service of the university hospital which had level 1 trauma center properties between 01.01.2006 and 01.01.2010 were included in the study. Trauma scores such as Injury Severity Score (ISS), New Injury Severity Score (NISS), Glasgow Coma Scale (GCS) and Revised Trauma Score (RTS) were calculated by screening the files and computer records of the patients during clinic visits. The average of ISS, NISS, RTS and GCS scores were statistically significant in pediatric trauma patients in whom mortality was observed than in the patients without mortality observed (p=0.001). The average of ISS, NISS, RTS and GCS scores were statistically significant in adult trauma patients in whom mortality was observed than in the patients without mortal...
The prognostic importance of trauma scoring systems in pediatric patients
Pediatric Surgery International, 2009
Purpose Traumas are among important causes of morbidity and mortality in the pediatric group. Our aim was to evaluate the predicting effects of general trauma scores on mortality and morbidity rates. Methods The files of 74 patients, who were admitted to our hospital with trauma between the years 2006 and 2008, were retrospectively investigated. Patients’ ages, sex, types of trauma, the time between the trauma and entrance to the hospital, vital and laboratory findings, length of hospital stay, length of intensive care unit (ICU) stay, surgical interventions, the organs affected by the trauma, morbidity, and mortality rates were recorded., glasgow coma scale (GCS), abbreviated injury scale (AIS), trauma score—injury severity score (TRISS), revised trauma score (RTS), injury severity score (ISS), pediatric trauma score (PTS), specific trauma scores for lung, liver, and spleen were calculated using the data in the files. Results The mean age of patients was 7.0 ± 4.34 (1–16) years and 50% of them were men. The types of the trauma were blunt in 66 (89.2%) patients, penetrating in 5 (6.8%) patients and injury due to gun shot in 3 (4.1%) patients. The mean time between the trauma and entrance to the emergency service was 80.40 ± 36.67 (10–120) min. Emergency operation and elective surgery was performed in 13 (17%) and 20 (27%) patients, respectively. The mean length of hospitalization was 4.50 ± 7.93 (1–35) days.Seven (9.5%) patients needed ICU. The morbidity and mortality rates were 60.8% (n = 45) and 2.7% (n = 2), respectively. AIS, ISS, TRISS and PTS were independent predictors of morbidity (p p p Conclusion ISS was found to be more valuable than other trauma scoring systems for prognostic evaluation of pediatric trauma patients. On the other hand, blood glucose, AST, and ALT are easily available, cheap, and valuable alternative laboratory findings in prognostic evaluation.
Children
The shock index (SI) is a useful tool for predicting the injury severity and mortality in patients with trauma. However, pediatric physiology differs from that of adults. In the pediatric trauma population, the shock status may be obscured within the normal range of vital signs. Pediatric age-adjusted SI (SIPA) is reported more accurately compared to SI. In our study, we conducted a 10 year retrospective cohort study of pediatric trauma population to evaluate the SI and SIPA in predicting mortality, intensive care unit (ICU) admission, and the need for surgery. This retrospective cohort study included 1265 pediatric trauma patients from January 2009 to June 2019 at the Taipei Tzu Chi Hospital, who had a history of hospitalization. The primary outcome of this investigation was in-hospital mortality, and the secondary outcomes were the length of hospital and ICU stay, operation times, and ICU admission times. The SIPA group can detect changes in vital signs early to reflect shock prog...
2015
Traumatic injuries are the leading cause of mortality and morbidity during childhood. A retrospective study was performed to evaluate the impact of Pediatric Trauma Score (PTS) on burden of trauma in emergency care. Children admitted to the emergency room were retrospectively evaluated for age, sex, mechanism of injury, physical examination findings, and PTS. The cost of trauma was obtained by medical records. A total of 146 patients (male/female: 93/53) were enrolled. The median age was 6 (interquartile range: 3-9.25). Mechanism of injury was falls (74%), motor vehicle crashes (9.6%), non-vehicular accidents (7.5%), struck by/against (6.2%), and cuts and gunshots (2.1%). The median PTS was 10. In the evaluation of trauma burden, radiologic investigations accounted for 41%, consultations for 23.5%, laboratory investigations for 15.6%, emergency surgical interventions for 12.1%, and medical interventions for 6.8 % of total trauma cost in emergency care. PTS showed no impact on burden...
Journal of Ayub Medical College, Abbottabad : JAMC, 2015
BACKGROUND Trauma scores help classify trauma patients, and assist in clinical decision-making. The Revised Trauma Score (RTS) is widely used internationally but its effectiveness as a tool for predicting outcome in paediatric trauma patients in our setting, has yet to be established, mainly owing to lack of use. The aim of this study was to determine the effectiveness of RTS as a predictor of outcome in paediatric trauma patients in Pakistan. METHODS We conducted a retrospective review of patient medical records at Aga Khan University Hospital, Karachi, from October 2006 to October 2009 and all patients aged less than 14 years, presenting with trauma were selected. Information was collected regarding demographics, vital signs at the time of presentation, length of stay (LOS) in the ward, ICU and the hospital, complications during hospital stay and mortality. Data was analysed in SPSS-17.0. RESULTS The sample was 501 patients with a mean age of 5.3 years. Two third (66%) were males ...
To Evaluate the Association of the Pediatric Trauma Score to Triage Severity of Children Injuries
2018
Trauma is the leading cause of pediatric mortality and morbidity in the world, but there is no widely accepted trauma scoring criteria for the rapid triage of acute injuries in children. The objective of this study was to evaluate the association of the Pediatric Trauma Score (PTS) with central nervous system injury (CNS) and solid organ injury (SOI), subspecialist operative management, and emergency department (ED) disposition in pediatric trauma patients. Our hypothesis was that PTS would be adequately associated with these outcomes. Our results included 3,817 patients, the average age was 7.25 years; 66.1% were male; and 98.4% sustained blunt trauma. Mean PTS value was 10.0. PTS had an outstanding association with mortality (AUC: 0.996; SE: 0.001). PTS had an acceptable association with CNS injury
Turkish Journal of Trauma and Emergency Surgery, 2015
BACKGROUND: Trauma is a major cause of disability and death among children worldwide, particularly in developed countries. The present aim was to compare efficacies of the Pediatric Trauma score (PTS), the Glasgow Coma Scale score (GCS), and the Injury Severity Score (ISS) in the prediction of mortality in children injured by trauma. METHODS: A total of 588 children admitted to the emergency ward of the Poursina Medical and Educational Center from 2010-2011 with trauma were included. The PTS, GCS, and ISS were calculated for all patients. Predictive efficacy of these scores was compared using receiver operating characteristic (ROC) curve with 95% confidence interval. RESULTS: Of the patient population, 62.1% were male and 37.9% female, with a mean age of 7.31±3.8 years. Road accident (42.2%) was the most common cause of injury. Overall, 2.4% of participants died. Regarding the prediction of mortality, the best cutoff point for the GCS was ≤8, with 98.4% sensitivity and 92.3% specificity. The same point for the PTS was ≤0.5, with 100% sensitivity and 31% specificity. For the ISS it was ≥16.5, with 92.5% sensitivity and 62% specificity. All variables based on mortality prediction were statistically significant (p<0.0001). CONCLUSION: When compared to the PTS and ISS, the GCS may be a better predictor of mortality in cases of childhood trauma.
The impact of Pediatric Trauma Score on burden of trauma in emergency room care
The Turkish journal of pediatrics
Traumatic injuries are the leading cause of mortality and morbidity during childhood. A retrospective study was performed to evaluate the impact of Pediatric Trauma Score (PTS) on burden of trauma in emergency care. Children admitted to the emergency room were retrospectively evaluated for age, sex, mechanism of injury, physical examination findings, and PTS. The cost of trauma was obtained by medical records. A total of 146 patients (male/female: 93/53) were enrolled. The median age was 6 (interquartile range: 3-9.25). Mechanism of injury was falls (74%), motor vehicle crashes (9.6%), non-vehicular accidents (7.5%), struck by/against (6.2%), and cuts and gunshots (2.1%). The median PTS was 10. In the evaluation of trauma burden, radiologic investigations accounted for 41%, consultations for 23.5%, laboratory investigations for 15.6%, emergency surgical interventions for 12.1%, and medical interventions for 6.8% of total trauma cost in emergency care. PTS showed no impact on burden ...
Development of a novel age-specific pediatric trauma score
Journal of Pediatric Surgery, 2001
Background/Purpose: Trauma scoring systems are needed to provide efficient triage of injured patients and to assess differences in outcomes and quality of care between different trauma centers, Current scoring systems used in pediatric trauma are not age specific, and thus have significant limitations.
Background: Pediatric trauma remains the leading cause of emergency department (ED) presentation and death around the world.1 In 2016, the WHO estimated that injuries accounted for 644,855 death and between 10 million and 30 million suffered non-fatal injuries among children under the age of 15. Objective: Was to assess the outcome of pediatric trauma in level 1 trauma center KAMC, Riyadh, kingdom of Saudi Arabia. Method: This study was conducted in the King Abdulaziz Medical City (KAMC). Data was collected from the medical records of all patients admitted during the study period who meet the inclusion criteria. The study was cross sectional involving chart review with a retrospective design. Results: Between January 2010 to December 2015, 1372 cases was presented to pediatric emergency department. Between ages 0 to 14 years old as a trauma cases. The most common mechanism of injury is Fall followed by Motor Vehicle accident. Severity of injury which manifested by Glasgow coma scale which showed 183 cases (13.3%) was <9 and 96 cases (7%) is 9-12, respectively. Musculoskeletal injuries is the most common involved system 514 cases (37.5%), followed by others injuries Conclusion: This study found that the most affected pediatric age is from 4 to 14 years. Also, found the majority of the cases survived the injuries. The commonest mechanism is fall followed by motor vehicle accident. Finally,37% of the patients suffered from musculoskeletal injuries.