Dündar Mehmet Akif, Can Sedanur Tekin, Akyıldız Başak Nur
Department of Pediatrics, Pediatric Intensive Care Unit, Erciyes University Faculty of Medicine, Kayseri, Türkiye.
Department of Pediatrics, Erciyes University Faculty of Medicine, Kayseri, Türkiye.
Turk Arch Pediatr. 2025 Jul 1;60(4):391-397. doi: 10.5152/TurkArchPediatr.2025.25040.
Objective: This study aimed to evaluate the effectiveness of various trauma scoring systems in predicting mortality in pediatric patients with multiple trauma and to determine their cut-off values. Materials and Methods: A methodological study was conducted on pediatric patients under 18 years of age admitted to the pediatric intensive care unit for multiple trauma. Demographic data, clinical parameters, and trauma scores, including the Revised Trauma Score (RTS), Pediatric Trauma Score (PTS), Glasgow Coma Scale (GCS), Abbreviated Injury Scale (AIS), Injury Severity Score (ISS), Pediatric Risk of Mortality Score III (PRISM-3), and Pediatric Logistic Organ Dysfunction (PELOD-2), were collected and analyzed. Results: Among the 107 patients, there were 15 deaths (14%). Significant differences were observed between survivors and non-survivors in all trauma scores. Non-survivors had higher AIS, ISS, PRISM-3, and PELOD-2 scores, while survivors had higher PTS, RTS, and GCS scores (P < .001). In the multivariate binary logistic regression analysis, both ISS (odds ratio [OR] 1.060 [95% CI: 1.029-1.092], P < .001) and RTS (OR 0.059 [95% CI: 0.007-0.517], P =.011) were independently associated with mortality. Injury Severity Score demonstrated the highest area under the curve (AUC) value of 0.98 in the receiver operating characteristic (ROC) analysis. Conclusion: Both ISS and RTS were identified as independent predictors of mortality in pediatric trauma patients. Injury Severity Score was the strongest predictor, while RTS also provided significant prognostic value. Integration of these scores into early assessment may enhance risk stratification and support clinical decision-making in pediatric trauma care.
本研究旨在评估各种创伤评分系统在预测多发伤儿科患者死亡率方面的有效性,并确定其截断值。材料与方法:对入住儿科重症监护病房的18岁以下多发伤儿科患者进行了一项方法学研究。收集并分析了人口统计学数据、临床参数和创伤评分,包括修订创伤评分(RTS)、儿科创伤评分(PTS)、格拉斯哥昏迷量表(GCS)、简明损伤量表(AIS)、损伤严重度评分(ISS)、儿科死亡风险评分III(PRISM - 3)和儿科逻辑器官功能障碍评分(PELOD - 2)。结果:107例患者中,有15例死亡(14%)。在所有创伤评分中,幸存者和非幸存者之间观察到显著差异。非幸存者的AIS、ISS、PRISM - 3和PELOD - 2评分较高,而幸存者的PTS、RTS和GCS评分较高(P <.001)。在多变量二元逻辑回归分析中,ISS(比值比[OR] 1.060 [95%置信区间:1.029 - 1.092],P <.001)和RTS(OR 0.059 [95%置信区间:0.007 - 0.517],P =.011)均与死亡率独立相关。在受试者工作特征(ROC)分析中,损伤严重度评分显示曲线下面积(AUC)值最高,为0.98。结论:ISS和RTS均被确定为儿科创伤患者死亡率的独立预测因素。损伤严重度评分是最强的预测因素,而RTS也提供了显著的预后价值。将这些评分纳入早期评估可能会加强儿科创伤护理中的风险分层并支持临床决策。