Risk Adjustment Measures and Outcome Measures for Prehospital Trauma Research: Recommendations from the Emergency Medical Services Outcomes Project (EMSOP)

Beskind, Daniel; Keim, Samuel M.; Spaite, Daniel W.; Garrison, Herbert G.; Lerner, E. Brooke; Howse, David; Maio, Ronald F.

doi:10.1111/j.1553-2712.2011.01148.x

Cited by 7 publications

(1 citation statement)

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“…We have developed the ped-ABC score, which consisted of vital signs and FAST. Tachycardia and hypotension as well as decreased GCS were associated with poor outcomes in the pediatric patients with trauma [18][19][20]. In addition, positive result of FAST strongly suggests intraabdominal injury that is one of the main reasons for the need of transfusion [21,22].…”

Section: Development Of Ped-abc Scorementioning

confidence: 99%

Assessment of Blood Consumption score for pediatrics (ped-ABC score) predicts transfusion requirements for children with trauma.

Komori

Deshpande

Aoki

et al. 2020

Preprint

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Background Although transfusion is one of primary life-saving elements, the assessment of requirement for transfusion in children with trauma at an early phase has been challenging. We aimed to develop a scoring system for predicting transfusion requirements in children with trauma. Methods This is a retrospective cohort study, which employed a nationwide registry of patients with trauma (Japan Trauma Data Bank) and included the patients aged < 16 years with blunt trauma between 2004 and 2015. An Assessment of Blood Consumption score for pediatrics (ped-ABC score) was developed based on previous literatures and clinical relevance. One point was assigned for each of the following criteria: systolic blood pressure ≤ 90 mmHg; heart rate ≥ 120/min; Glasgow Coma Scale (GCS) < 15; and positive result on focused assessment with sonography for trauma (FAST) scan. For sensitivity analysis, we assessed age-adjusted ped-ABC scores using cut-off points for different ages. Results In total, 540 patients had transfusion within 24 hours after trauma among the eligible 5,943 pediatric patients with trauma. The in-hospital mortality rate was 2.6% (145/5,615). Transfusion increased from 7.6% (430/5,631) to 35.3% (110/312) in patients with systolic blood pressure ≤ 90 mmHg (1 point); from 6.1% (276/4,504) to 18.3% (264/1,439) for heart rate ≥ 120/min (1 point); from 4.1% (130/3,198) to 14.9% (410/2,745) for disturbance of consciousness with GCS < 15 (1 point); and from 7.4% (400/5,380) to 24.9% (140/563) for FAST positivity (1 point). The ped-ABC score of 0, 1, 2, 3, and 4 points were associated with the transfusion rates of 2.2% (48/2,210), 7.5% (198/2,628), 19.8% (181/912), 53.3% (88/165), and 89.3% (25/28), respectively. After age adjustment, c-statistic was 0.76 (95% CI, 0.74–0.78). Conclusions The ped-ABC score using the vital signs and FAST may be helpful in predicting the transfusion requirements within 24 hours for children with trauma.

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