Pediatric trauma BIG score: Predicting mortality in polytraumatized pediatric patients

Abstract

Background:Trauma is a worldwide health problem and the major cause of death and disability, particularly affecting the young population. It is important to remember that pediatric trauma care has made a significant improvement in the outcomes of these injured children.Aim of the Work:This study aimed at evaluation of pediatric trauma BIG score in comparison with New Injury Severity Score (NISS) and Pediatric Trauma Score (PTS) in Tanta University Emergency Hospital.Materials and Methods:The study was conducted in Tanta University Emergency Hospital to all multiple trauma pediatric patients attended to the Emergency Department for 1 year. Pediatric trauma BIG score, PTS, and NISS scores were calculated and results compared to each other and to observed mortality.Results:BIG score ≥12.7 has sensitivity 86.7% and specificity 71.4%, whereas PTS at value ≤3.5 has sensitivity 63.3% and specificity 68.6% and NISS at value ≥39.5 has sensitivity 53.3% and specificity 54.3%. There was a significant positive correlation between BIG score value and mortality rate.Conclusion:The pediatric BIG score is a reliable mortality-prediction score for children with traumatic injuries; it uses international normalization ratio (INR), Base Excess (BE), and Glasgow Coma Scale (GCS) values that can be measured within a few minutes of sampling, so it can be readily applied in the Pediatric Emergency Department, but it cannot be applied on patients with chronic diseases that affect INR, BE, or GCS.

Predicting mortality, hospital length of stay and need for surgery in pediatric trauma patients

“…The findings of a study showed that NISS had sensitivity of 53.3% at cut-off value ≤39.5 and specificity of 54.3% for predicting mortality. 8 The observed difference in cut-off value of anatomic scoring systems between our study and other study can be due to delay in delivering the medical care to injured patients.…”

“…The scoring systems can be used for timely delivering medical support and preparing the patient for surgery in early stage. 8 The most frequently used ones are general scoring systems used in both adult and pediatric patients. In our study, we evaluated the relation of ISS, NISS, RTS with mortality, hospital LOS and need for surgery in pediatric patients.…”

“…These scoring systems can also be used for timely delivering medical support and preparing the patient for surgery in early stage. 8 The scores of ISS and NISS have demonstrated association with interested outcomes of mortality, length of hospital stay among adult and pediatric trauma patients. 9 , 10 However, there is limited information about comparison of the anatomic and physiologic scoring system in predicting the outcome of need for surgical interventions in trauma patients.…”

Assessment of Circulatory Management in Pediatric Polytrauma According to International Guidelines in Suez Canal University Hospital

“…Moreover, in the current study, all patients with GCS <8 at presentation were died (p<0.001). Similarly, in the study of El-Gamasy and his colleagues (17) , when comparing GCS between survivors and non-survivors, non-survivors had a significantly lower GCS. Similarly, a research by Gill et al (18) demonstrated that GCS can predict long-term health consequences following a head injury.…”

“…Self-breathing was reported in about 70% of patients. El-Gamasy et al (17) undertook a study to evaluate the accuracy of the pediatric trauma BIG score in predicting death in patients with multiple injuries, and found that only 25% of the patients had uncontrollable breathing problems.…”