Introduction Trauma is one of the major causes of death among all age groups. It is the leading cause of death and disability among children older than 1 year of age (1). In addition to designing pre-hospital and hospital trauma organizations, taking meticulous preventive measures and providing public education are greatly important for efforts aimed at reducing trauma-related mortality (2). Initial assessment and management of multi-trauma patients is a difficult task requiring a rapid and systematic approach. According to the ATLS principles, injured patients are assessed and treated based on their vital signs, level of consciousness, and injury mechanism (3). Additionally, a variety of trauma severity scoring systems has been devised to predict trauma severity and to predict and prevent trauma-related death (4). Trauma severity scoring refers to the process of prediction and quantification of the risks associated with death, hospitalization, and discharge (5). Trauma severity scores assess trauma in terms of its anatomic and/or physiological properties. abbreviated injury scale (AIS) and injury severity score (ISS) take into account injury's anatomic Aim: We aimed to evaluate and compare the performance of BIG score (Base deficit, INR, GCS), pediatric trauma score, revised trauma score, injury severity score, new injury severity score (NISS) in mortality and stay intensive care unit. Materials and Methods: One thousand five hundred ten pediatric patients aged less than 18 years who were admitted to the emergency department with multi-trauma between 1 July 2012 and 1 July 2016 were included in the retrospective research. Demographic data, vital signs in the emergency department, trauma location, injury severity indexes and follow up of patients were examined. Results: One thousand five hundred ten patients were included, 40.5% were female and 59.5% were male. Mean age was 7.81±4.8; mortality was 4.2%. The best score to evaluate mortality was "probability of survival 2014 (PS14)". The best score to force the stay in ICU was found as NISS, the most sensitive system was NISS and PS14 (94.9%) and the most specific was NISS (86.7). PS14 was the first to evaluate the survival. In our research, 94.3% of patient had blunt trauma and 5.7% had penetrating trauma. PS14 was found the best score to determine survival and mortality for blunt trauma patients. Conclusion: Although all scoring systems appeared similarly predictive among pediatric trauma patients, The PS14 score was more predictive for mortality and survival, and the NISS score for the need of intensive care admission. The NISS score was the most predictive score for intensive care admission in blunt and penetrating traumas combined. Particularly the newly developed PS14 score can be used as a powerfully predictive scoring system for outcomes among all pediatric trauma patients, irrespective of trauma mechanism.
BACKGROUND: The impact of coronavirus disease-2019 (COVID-19) on geriatric trauma presenting to the emergency department is unknown. OBJECTIVE: To examine geriatric trauma emergency department admission trends during the COVID-19 pandemic. METHODS: This retrospective, observational, comparison study was conducted in an academic emergency department in Turkey. Trauma patients 65 years and older who presented to the emergency department within 1 year of March 12, 2020, were included. Patients admitted in the same date range in the previous year were included as the control group. The characteristics of the patients, injured area, and injury mechanisms were compared. RESULTS: Geriatric trauma admissions decreased (relative risk = 0.71, odds ratio [OR] = 0.69 [95% confidence interval, CI: 0.62, 0.77], p < .001). According to the type of injury, there was no significant difference in admissions to the emergency department (p = .318). During the pandemic, there was an increase in falls and a decrease in stab wounds and gunshot wounds (p = .001). Multiple trauma (OR = 5.56 [95% CI: 3.75, 8.23], p < .001), fall (OR = 2.41 [95% CI: 1.6, 3.73], p < .001), and-assault related injuries (OR = 4.43 [95% CI: 2.06, 9.56], p < .001) were determined as factors that increased the admissions to the emergency department compared with the prepandemic. CONCLUSION: Although geriatric trauma emergency department admissions decreased during the pandemic, those due to falls and assaults increased. Although curfews and social isolation resulted in a decrease in penetrating injuries, assault-related trauma has increased.
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