The pediatric trauma score as a predictor of injury severity in the injured child

Tepas, Joseph J.; Mollitt, Daniel L.; Talbert, James L.; Bryant, M. G.

doi:10.1016/s0022-3468(87)80006-4

Cited by 301 publications

(133 citation statements)

References 11 publications

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“…In the first study on the PTS, Tepas et al 7,9 determined a statistically significant linear relationship between the PTS and the Injury Severity Score. Following this, its validity was confirmed for predicting mortality, with a sensitivity of 95.8% and a specificity of 98.6% for the PTS.…”

Section: Discussionmentioning

confidence: 99%

“…The validity of the pediatric Glasgow Coma Score (GDC), Trauma Score, Revised Trauma Score, and the Pediatric Trauma Score (PTS) has been proven. [6][7][8] Developed in 1987 by Tepas et al 9 the PTS is patterned after the evaluation process of the Advanced Trauma Life Support (ATLS), and it is specifically designed for the triage of children with traumatic injury. 5 It is the sum of six parameters incorporating size as a surrogate for age and vital signs plus organ-specific injury data.…”

Section: Introductionmentioning

confidence: 99%

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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: 99%

Section: Introductionmentioning

confidence: 99%

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

Anıl¹,

Sarıtaş²,

Bıcılıoğlu³

et al. 2017

cayd

View full text Add to dashboard Cite

show abstract

“…These patients had a mean age of 47.2 (±26.4) years and a mean ISS of 20.9 (±4.6; range [16][17][18][19][20][21][22][23][24][25][26][27][28][29]. Almost two-third of these false negatives incurred extremity (66.7%) injuries, whereas only 39.6% of the other major trauma patients, the true positives, sustained extremity injuries (p=0.068).…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, children were excluded from the study population because children have other physiological and anatomic responses to trauma. Specific trauma scores, such as the pediatric trauma score have been developed for children [29]. We are conducting a study to evaluate the prehospital predictive value of these trauma scores for severely injured children.…”

Section: Discussionmentioning

confidence: 99%

Prehospital identification of major trauma patients

Ocak

Sturms

Hoogeveen

et al. 2008

Langenbecks Arch Surg

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Background and aims Prehospital triage is aimed at getting the right patient to the right hospital. Evaluations on the performance of prehospital triage tools are scarce. This study examines the ability of the American College of Surgeons' Committee on Trauma (ACSCOT) triage guidelines to identify major trauma patients in a European trauma system. Furthermore, this study evaluates the predictive power of other prehospital measurements. Materials and methods Prehospital data of 151 minor (Injury Severity Score (ISS) 1-15) and 151 major trauma patients, (ISS>15) treated at a Dutch trauma center, were collected. Logistic regression analysis was used to identify predictors of major trauma patients. Results The major trauma patients particularly incurred severe head injuries (45.7%) and severe thorax injuries (21.9%). The ACSCOT guidelines had a sensitivity of 84.1% and a specificity of 77.5%. A new prehospital trauma triage model was constructed including nine predictors of major trauma. This model identified more major trauma patients than the ACSCOT (sensitivity 92.1%, p=0.023) and resulted in a comparable specificity (79.5%; p=0.711). Conclusion The new triage model outperforms the ACS COT triage guidelines in identifying major trauma patients in the prehospital setting. The new triage guidelines may improve patient outcomes but needs to be validated in a prospective study.

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“…Esta quantificação tem fundamental importância, pois permite fazer a triagem dos pacientes mais graves, além de avaliar a qualidade do serviço prestado. A Escala de Trauma pediátrico (ETP) 34,35 , desenvolvida unicamente para dimensionar as lesões traumáticas em crianças, tem-se demonstrado eficaz para graduar a gravidade.…”

Section: Transporte Da Criança Politraumatizadaunclassified

Inicial care in severe pediatric trauma

Abramovici

Souza²

1999

J Pediatr (Rio J)

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ResumoObjetivos: Apresentar de forma objetiva e prática a abordagem terapêutica da criança vítima de trauma.Métodos: Foram revisados artigos da literatura, selecionandose aqueles que tratam das questões envolvendo a abordagem e o tratamento da criança com trauma.Resultados: A criança apresenta grande potencial de recuperação, porém a ressuscitação inadequada é considerada a maior causa de óbitos por trauma passível de prevenção. Cuidados na abertura e manutenção da via aérea, na oferta adequada de fluido para a criança vítima de politraumatismo e queimaduras, assim como no diagnóstico precoce e tratamento efetivo de hemorragias internas melhoram o prognóstico e reduzem drasticamente as taxas de mortalidade.O atendimento inicial da criança vítima de politraumatismo exige imediato tratamento da falência respiratória, do choque e das lesões de tórax com risco de vida para assegurar efetividade de ventilação, oxigenação e perfusão até o tratamento definitivo. Simultaneamente, a coluna cervical deve ser protegida de possível lesão já existente ou aparecimento de futura lesão.Conclusões: Medidas efetivas de prevenção de acidentes, leis rigorosas de proteção à criança e ao adolescente, associadas ao treinamento no atendimento ao politraumatismo reduziriam significativamente os preocupantes índices de morbi-mortalidade em nosso país.J. pediatr. (Rio J.). 1999; 75 (Supl.2): S268-S278: politrauma, criança politraumatizada, trauma, queimaduras. AbstractObjectives: To present objectively the therapeutic aspects for the management of child victim of trauma.Methods: The most relevant articles about the management of acute trauma were selected.Results: Children possess great potential for recovery after a trauma, however, inappropriate resuscitation is the major cause of death preventable.Care in the opening and maintenance of the airways, adequate input of fluid to the child victim of politrauma or burns as well as prompt diagnosis and effective management to internal bleeding has improved prognosis and can reduce mortality considerably. Initial assessment and management of the injured child requires immediate procedures towards respiratory failure, shock and life-threatening thoracic injuries in order to provide efficient ventilation, oxygenation and perfusion until definitive treatment is performed. Concomitantly, the cervical spine should be protected against new injuries or progression of established injury.Conclusions: Effective actions in order to prevent accidents and rigorous laws to protect children and adolescents, associated to training and practice of specific procedures to the politraumatized child could surely reduce the unacceptable morbi-mortality in our country.J. pediatr. (Rio J.). 1999; 75 (Supl.2): S268-S278: pediatric injury, pediatric trauma, injured child, polytrauma, burns. Presidente do Departamento de Emergências da IntroduçãoTrauma é a doença do século XX e pode ser classificada corretamente como uma epidemia que, se não forem tomadas medidas eficazes para um programa nacional de prevenção, deverá ...

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The pediatric trauma score as a predictor of injury severity in the injured child

Cited by 301 publications

References 11 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

Prehospital identification of major trauma patients

Inicial care in severe pediatric trauma

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