Kinjalk Meghna, Jain Nitin, Neogi Sujoy, Ratan Simmi K, Panda Shasanka Shekhar, Sehgal Mehak, Arora Vanshika
Department of Pediatric Surgery, Maulana Azad Medical College, New Delhi, India.
Department of Pediatric Surgery, AIIMS, Bibinagar, Telangana, India.
J Indian Assoc Pediatr Surg. 2024 Jan-Feb;29(1):33-38. doi: 10.4103/jiaps.jiaps_156_23. Epub 2024 Jan 12.
The Shock Index Pediatric Age-Adjusted (SIPA) score is a useful tool for identifying pediatric trauma patients at a risk of poor outcomes and for triaging. We are studying the relationship between elevated SIPA score and specific outcomes in pediatric trauma patients.
A retrospective study was conducted in which case records of 58 pediatric patients with blunt abdominal trauma were evaluated and tabulated for their SIPA scores only at the time of their initial presentation and categorized into two groups - normal SIPA and elevated SIPA. The primary outcomes were need for blood transfusion, need for any intervention, and need for emergency surgery, and the secondary outcomes were need for computed tomography (CT) scan, need for a ventilator, intensive care unit (ICU) stay, length of hospital stay, and mortality. Statistical methods were applied to find a relationship between elevated SIPA score and the primary and secondary outcomes.
An elevated SIPA score was noted in 27 (46%) patients. There was a significant relationship between elevated SIPA scores and patients needing blood transfusion (68.75%, = 11) and length of hospital stay (10.48 ± 7.54 days). A significant relationship between elevated SIPA score and need for emergency surgery (54.54%, = 6), need for a CT scan (56%, = 14), and ICU stay (50%, = 2) was not found.
We have seen in our study that elevated SIPA scores at presentation are significantly related to need for blood transfusion and length of hospital stay. In more than half of the patients, elevated SIPA was associated with need for emergency surgery and requirement of CT scan, but it was statistically not significant. Therefore, assessment of this parameter can help in identifying such poor outcomes.
小儿年龄校正休克指数（SIPA）评分是识别预后不良的小儿创伤患者及进行分诊的有用工具。我们正在研究小儿创伤患者中SIPA评分升高与特定预后之间的关系。
进行了一项回顾性研究，评估了58例钝性腹部创伤小儿患者的病例记录，并仅在其初次就诊时将其SIPA评分制成表格，分为两组——正常SIPA组和升高SIPA组。主要预后指标为输血需求、任何干预需求和急诊手术需求，次要预后指标为计算机断层扫描（CT）需求、呼吸机需求、重症监护病房（ICU）住院时间、住院时间和死亡率。应用统计方法来寻找SIPA评分升高与主要和次要预后指标之间的关系。
27例（46%）患者SIPA评分升高。SIPA评分升高与需要输血的患者（68.75%，=11）和住院时间（10.48±7.54天）之间存在显著关系。未发现SIPA评分升高与急诊手术需求（54.54%，=6）、CT扫描需求（56%，=14）和ICU住院时间（50%，=2）之间存在显著关系。
我们在研究中发现，就诊时SIPA评分升高与输血需求和住院时间显著相关。在超过一半的患者中，SIPA升高与急诊手术需求和CT扫描需求相关，但在统计学上不显著。因此，对该参数的评估有助于识别此类不良预后。
