Predictors of mortality in pediatric trauma: experiences of a level 1 trauma center and an assessment of the International Classification Injury Severity Score (ICISS).
Pediatr Surg Int
; 32(7): 657-63, 2016 Jul.
Article
en En
| MEDLINE
| ID: mdl-27255740
ABSTRACT
OBJECTIVES:
Injury severity scoring tools allow systematic comparison of outcomes in trauma research and quality improvement by indexing an expected mortality risk for certain injuries. This study investigated the predictive value of the empirically derived ICD9-derived Injury Severity Score (ICISS) compared to expert consensus-derived scoring systems for trauma mortality in a pediatric population.METHODS:
1935 consecutive trauma patients aged <18 years from 1/2000 to 12/2012 were reviewed. Mechanism of injury (MOI), Injury Severity Score (ISS), Revised Trauma Score (RTS), Trauma Score ISS (TRISS), and ICISS were compared using univariate and multivariate logistic regression analysis and receiver operator characteristic analysis.RESULTS:
The population was a median age of 11 ± 6 year, 70 % male, and 76 % blunt injury. Median ISS 13 ± 12 and overall mortality 3.5 %. Independent predictors of mortality were initial hematocrit [odds ratio (OR) 0.83 (0.73-0.95)], HCO3 [OR 0.82 (0.67-0.98)], Glasgow Coma Scale score [OR 0.75 (0.62-0.90)], and ISS [OR 1.10 (1.04-1.15)]. TRISS was superior to ICISS in predicting survival [area under receiver operator curve 0.992 (0.982-1.000) vs 0.888 (0.838-0.938)].CONCLUSIONS:
ICISS was inferior to existing injury scoring tools at predicting mortality in pediatric trauma patients.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Centros Traumatológicos
/
Heridas y Lesiones
/
Índices de Gravedad del Trauma
Tipo de estudio:
Prognostic_studies
/
Risk_factors_studies
Límite:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
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Infant
/
Male
/
Newborn
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Pediatr Surg Int
Asunto de la revista:
PEDIATRIA
Año:
2016
Tipo del documento:
Article
País de afiliación:
Estados Unidos