Outcomes of Emergency Department Thoracotomy in Pediatric Gunshot Victims: Designation Matters

Abstract

Score (TRISS), Injury Severity Score (ISS), Shock Index (SI), and NISS. Receiver operating characteristic curves (ROC) were used to evaluate the sensitivity and specificity of trauma scores for predicting mortality.RESULTS: A total of 738 patients were included (mean age: 35.7AE15.6 years). ROC curves demonstrated that NISS (AUC¼0.83, 95%CI: 0.79-0.87, p<0.001) were the best predictor of mortality, followed by TRISS (AUC¼0.80, 95%CI: 0.73-0.87, p<0.001) and GCS (AUC¼0.80, 95%CI: 0.74-0.85, p<0.001), ISS (AUC¼0.76, 95%CI: 0.71-0.81, p<0.001), RTS (AUC¼0.71, 95%CI: 0.62-0.81, p<0.001), and SI (AUC¼0.63, 95%CI: 0.57-0.70, p<0.001). NISS was superior in predicting mortality for penetrating trauma (AUC¼0.86AE0.02, p<0.001) compared to blunt trauma (AUC¼0.73AE0.04, p<0.001).CONCLUSION: NISS was the best scoring index for predicting mortality in trauma patients, especially for penetrating trauma. Clinicians should consider incorporating other trauma scores, especially NISS, in determining injury severity and the likelihood of mortality. These scores can help physicians determine the best course of action in patient management.