Pediatric applied trauma research network: a call to action

Upperman, Jeffrey S.; Burd, Randall S.; Cox, Charles S.; Ehrlich, Peter F.; Mooney, David P.; Groner, Judith A.

doi:10.1016/j.jpedsurg.2010.08.059

Cited by 6 publications

(5 citation statements)

References 22 publications

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“…1 Despite this, civilian research and evidenced-based guidelines specifically focused on injured children significantly lag behind their adult counterparts. 2 Military efforts have contributed a large proportion of pediatric trauma research by assessing injuries sustained within combat zones during recent conflicts in the Middle East. 3,4 However, the highly morbid nature of the surrounding environment often results in severe anatomic and physiologic derangements resulting in unique injury patterns experienced by this patient population.…”

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confidence: 99%

“…Trauma represents the leading cause of mortality for pediatric patients within the United States 1 . Despite this, civilian research and evidenced-based guidelines specifically focused on injured children significantly lag behind their adult counterparts 2 . Military efforts have contributed a large proportion of pediatric trauma research by assessing injuries sustained within combat zones during recent conflicts in the Middle East 3,4 .…”

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confidence: 99%

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Addition of neurological status to pediatric adjusted shock index to predict early mortality in trauma: A pediatric Trauma Quality Improvement Program analysis

Lammers

Marenco

Morte

et al. 2021

J Trauma Acute Care Surg

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Pediatric adjusted shock index (SIPA) has demonstrated the ability to prospectively identify children at the highest risk for early mortality. The addition of neurological status to shock index has shown promise as a reliable triage tool in adult trauma populations. This study sought to assess the utility of combining SIPA with Glasgow Coma Scale (GCS) for predicting early trauma-related outcomes. METHODS:Retrospective review of the 2017 Trauma Quality Improvement Program Database was performed for all severely injured patients younger than 18 years old. Pediatric adjusted shock index and reverse SIPA Â GCS (rSIG) were calculated. Age-specific cutoff values were derived for reverse shock index multiplied by GCS (rSIG) and compared with their SIPA counterparts for early mortality assessment using area under the receiver operating characteristic curve analyses. RESULTS:A total of 10,389 pediatric patients with an average age of 11.4 years, 67% male, average Injury Severity Score of 24.1, and 4% sustaining a major penetrating injury were included in the analysis. The overall mortality was 9.3%. Furthermore, 32.1% of patients displayed an elevated SIPA score, while only 27.5% displayed a positive rSIG. On area under the receiver operating characteristic curve analysis, rSIG was found to be superior to SIPA as a predictor for in hospital mortality with values of 0.854 versus 0.628, respectively. CONCLUSION:Reverse shock index multiplied by GCS more readily predicted in hospital mortality for pediatric trauma patients when compared with SIPA. These findings suggest that neurological status should be an important factor during initial patient assessment. Further study to assess the applicability of rSIG for expanded trauma-related outcomes in pediatric trauma is necessary.

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confidence: 99%

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confidence: 99%

Addition of neurological status to pediatric adjusted shock index to predict early mortality in trauma: A pediatric Trauma Quality Improvement Program analysis

Lammers

Marenco

Morte

et al. 2021

J Trauma Acute Care Surg

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“…Because the current results suggest that perhaps only the most severely affected children are being referred to inpatient rehabilitation, future studies should explore factors associated with decisions to admit to inpatient rehabilitation, and whether those less severely injured may benefit from such intensive therapy. To more comprehensively understand the complexities of disabling injuries in children, there has been a call for action to more robustly collect essential pediatric trauma outcomes data through multicenter research networks, 49 in addition to suggestions for useful standardized outcome measures, [50][51][52] rehabilitation quality of care measures, 53 and rehabilitation research design strategies. 54 …”

Section: Discussionmentioning

confidence: 99%

Physical Disability After Injury-Related Inpatient Rehabilitation in Children

2012

PEDIATRICS

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“…Pediatric trauma has also been reported as the primary cause of death after first year of life 3 . Many studies reported that the estimated direct medical cost associated with trauma is almost 10% of medical expenditure [4][5][6] .…”

Section: Introductionmentioning

confidence: 99%

Frequency of morbidity, mortality and renal trauma in blunt and firearm accidents in pediatric population.

Quraishi

Soomro

Chand

et al. 2021

Int. j. endorsing health sci. res.

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Background: Renal Trauma is one of the significant causes of deterioration, morbidity, and mortality in the pediatric age group around the globe. Firearm injuries are among one of the essential causes for renal trauma. Overall, trauma is the leading cause of death and accounts for approximately 50% of mortality in children over 1 year of age. Therefore, the current study aims to determine the frequency of morbidity, mortality and renal trauma in blunt and firearm accidents in pediatric population. Methodology: A total of 180 children, aged up to 15 years with blunt and penetrating trauma, including firearm injuries, were enrolled in our study. All patients with in the inclusion criteria of the study, who were presented in the emergency department were evaluated and resuscitated by a pediatric surgeon. Patients indicated with renal trauma were operated and were post-operatively managed in the pediatric surgery ward. All patients included were followed as an outpatient. The data of this descriptive case series were collected prospectively and was analyzed on SPSS version 22.0. Results: Out of 180 patients 110 (61.11%) were male and 70 (38.89%) were female with mean age of 8.5 ± 2.9 years. Majority of the patients had blunt trauma (54.44%) followed by firearm injuries (60, 33.33%). While penetrating trauma were observed in 22 patients (12.22%). Overall Renal trauma was observed in 40 (22.2%) of patients. Out of 40 patients, 20 (50%) patients had blunt, while 14 (35%) had firearm and 05 (12.5%) had penetrating abdominal trauma. Majority of renal injuries were Grade II (60%) followed by Grade III (17.5%), Grade IV (12.5%) and Grade I (10%) injury. The major morbidities noted in firearm injured patients were surgical site infection that was reported in 33.33% patients, limb deformity in 6.66% and neurological deficit in 5% patients. Overall Mortality was observed in 6.6% patients and firearm injuries was responsible for 8.33%. Conclusion: Firearm injuries are one of the significant causes of trauma in children. The renal trauma was observed in 22.2% of cases, and all were managed conservatively. The frequency of morbidity and mortality secondary to firearm injuries was high as compared to other studies.

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Pediatric applied trauma research network: a call to action

Cited by 6 publications

References 22 publications

Addition of neurological status to pediatric adjusted shock index to predict early mortality in trauma: A pediatric Trauma Quality Improvement Program analysis

Addition of neurological status to pediatric adjusted shock index to predict early mortality in trauma: A pediatric Trauma Quality Improvement Program analysis

Physical Disability After Injury-Related Inpatient Rehabilitation in Children

Frequency of morbidity, mortality and renal trauma in blunt and firearm accidents in pediatric population.

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