Evaluating the prognosis of multiple, severely traumatized children in the intensive care unit

Cantais, E.; Paut, O.; Giorgi, Roch; Viard, L.; Camboulives, J

doi:10.1007/s001340101039

Cited by 57 publications

(52 citation statements)

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“…17,18 However, its accuracy for the prediction of mortality is still debated. [19][20][21] In our study, the mortality rate was very low (1.8%), and all deaths occurred in patients in the STG (PTS ≤8). Their PTS scores were four or lower.…”

Section: Discussionmentioning

confidence: 56%

The Performance of the Pediatric Trauma Score in a Pediatric Emergency Department: A Prospective Study

Anıl¹,

Sarıtaş²,

Bıcılıoğlu³

et al. 2017

cayd

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Introduction:The aim of this study was to assess the efficacy of the Pediatric Trauma Score (PTS) in predicting significant trauma in patients presenting with blunt trauma to a high-level pediatric emergency department. Methods: Patients younger than 15 years of age presenting to the pediatric emergency department of the Tepecik Training and Research Hospital with acute high-energy blunt trauma were analyzed prospectively. The PTS was calculated on arrival at the pediatric emergency department. The patients were classified into two groups as follows: patients with a PTS of ≤8 comprised the significant trauma group, while patients with a PTS of >8 made up the non-significant trauma group. Results: Two-hundred-thirteen children with a mean age of 6.1±3.9 years (range: 10 days-15 years) were included in the study. The frequency of coagulation testing and thorax computed tomography in the pediatric emergency department, need for critical interventions and therapies in the pediatric emergency department, rate of hospitalization, need for transfer to the pediatric intensive care unit, mechanical ventilation, operation, blood transfusion, and mortality rate were statistically higher in the significant trauma group (p<0.05). PTS ≤8 exhibited a sensitivity of 56.2% and a specificity of 90.8% for hospitalization (AUROC: 0.682; 95% confidence interval: 0.610-0.755). The PTS was significantly correlated with length of hospital stay (r=-0.493; p<0.001) and length of observation in the pediatric emergency department (r=-0.442; p<0.01). Conclusion: PTS on arrival at a high-level pediatric emergency department is a good predictor of the need for critical interventions/ therapies and mortality in children with high-energy blunt trauma. However, its accuracy is moderate for the prediction of hospitalization. Keywords: Pediatric Trauma Score, high-energy trauma, mortality, hospitalization Amaç: Çalışmanın amacı, üst düzey bir çocuk acil servisine künt yüksek enerjili travma nedeniyle başvuran çocuklardaki ciddi travmayı öngörmede, Pediyatrik Travma Skoru'nun (PTS) etkin olup olmadığının araştırılmasıdır. Yöntemler: Akut künt yüksek enerjili travma nedeniyle Tepecik Eğitim ve Araştırma Hastanesi'ne başvuran 15 yaşından küçük çocuklar ileriye yönelik olarak incelendi. PTS yaralı acil servise geldiği anda hesaplandı. Hastalar iki gruba ayrıldı: PTS ≤8 (ciddi travma) ve PTS >8 (ciddi olmayan travma). Bulgular: İki yüz on üç çocuk (ortalama yaş: 6,1±3,9 yıl; en küçük: 10 gün -en büyük: 15 yıl) çalışmaya alındı. Acil serviste koagülasyon testi ve toraks tomografisi sıklığı, acil serviste kritik girişim ve tedavi gereksinimi, hastaneye yatış oranı, yoğun bakım gereksinimi, mekanik ventilatör gereksinimi, ameliyat, kan transfüzyonu, ölüm sıklığı PTS ≤8 grubunda daha fazlaydı (p<0,05). PTS ≤8'in duyarlılığı %56,2; özgüllüğü %90,8 (AUROC: 0,682; %95 CI: 0,610-0,755) olarak hesaplandı. PTS hastanede yatış süresi (r=-0,493; p<0,001) ve acil serviste izlenme süresi (r=-0,442; p<0,01) ile anlamlı korelasyon göstermekteydi. Sonuç: Künt yüksek en...

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Section: Discussionmentioning

confidence: 56%

The Performance of the Pediatric Trauma Score in a Pediatric Emergency Department: A Prospective Study

Anıl¹,

Sarıtaş²,

Bıcılıoğlu³

et al. 2017

cayd

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“…In a similar study including children with severe trauma in intensive care, Cantais et al reported that the same systems had significant association with mortality, though the GCS had the highest predictive ability. [21] Furthermore, in a study in which 11 trauma parameters were compared among children and adults, Otto et al reported that physical parameters, including the GCS, had higher predictive ability than those that were anatomical, including the PTS and ISS. [22] …”

Section: Discussionmentioning

confidence: 99%

Comparing Pediatric Trauma Score, Glasgow Coma Scale, and Injury Severity Score for Mortality Prediction in Traumatic Children

Yousefzadeh-Chabok

Leyli

Kouchakinejad–Eramsadati

et al. 2015

Ulus Travma Acil Cerrahi Derg

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“…28 Its use has been reported in children with TBI, 9,12 and PTS < 3 is associated with an increased rate of mortality. 3,12 Although widely used in the assessment of pediatric trauma patients, in this study the PTS failed to correlate with any of the physiological variables known to be associated with secondary insults.…”

Section: Pediatric Trauma Scorementioning

confidence: 56%

“…3,6,9,16 Given that sedation in the acute phase may influence 2 components of the GCS, (eye opening and verbal responses), the motor component of the GCS is often considered to represent a more reliable assessment. For preverbal children, the pediatric coma scale is preferred.…”

Section: Glasgow Coma Scalementioning

confidence: 99%

Acute clinical grading in pediatric severe traumatic brain injury and its association with subsequent intracranial pressure, cerebral perfusion pressure, and brain oxygenation

Figaji

Zwane

Fieggen

et al. 2008

FOC

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Object The goal of this paper was to examine the relationship between methods of acute clinical assessment and measures of secondary cerebral insults in severe traumatic brain injury in children. Methods Patients who underwent intracranial pressure (ICP), cerebral perfusion pressure (CPP), and brain oxygenation (PbtO2) monitoring and who had an initial Glasgow Coma Scale score, Pediatric Trauma Score, Pediatric Index of Mortality 2 score, and CT classification were evaluated. The relationship between these acute clinical scores and secondary cerebral insult measures, including ICP, CPP, PbtO2, and systemic hypoxia were evaluated using univariate and multivariate analysis. Results The authors found significant associations between individual acute clinical scores and select physiological markers of secondary injury. However, there was a large amount of variability in these results, and none of the scores evaluated predicted each and every insult. Furthermore, a number of physiological measures were not predicted by any of the scores. Conclusions Although they may guide initial treatment, grading systems used to classify initial injury severity appear to have a limited value in predicting who is at risk for secondary cerebral insults.

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Evaluating the prognosis of multiple, severely traumatized children in the intensive care unit

Cited by 57 publications

References 0 publications

The Performance of the Pediatric Trauma Score in a Pediatric Emergency Department: A Prospective Study

The Performance of the Pediatric Trauma Score in a Pediatric Emergency Department: A Prospective Study

Comparing Pediatric Trauma Score, Glasgow Coma Scale, and Injury Severity Score for Mortality Prediction in Traumatic Children

Acute clinical grading in pediatric severe traumatic brain injury and its association with subsequent intracranial pressure, cerebral perfusion pressure, and brain oxygenation

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