The Age-Specific Pediatric Trauma Score (ASPTS) of Potoka et al

Description

Potoka et al developed a pediatric trauma score using age-related reference ranges for physiologic measures. This can help identify a child at high risk for mortality. The authors are from the University of Pittsburgh and the Children's Hospital of Pittsburgh.

Age range: 0 to 16 years of age

Parameters:

(1) Glasgow Coma Score (GCS)

(2) systolic blood pressure

(3) pulse

(4) respiratory rate

Parameter	Finding	Points
Glasgow Coma Score	14 – 15	3
	10 – 13	2
	4 – 9	1
	3	0
systolic blood pressure	normal (mean for age) +/- (1 SD)	3
	mild to moderate hypotension (blood pressure) < (mean for age) – (2 SD)	2
	severe hypotension (blood pressure) < (mean for age) – (3 SD)	1
	0	0
pulse	normal (mean for age) +/- (1 SD)	3
	tachycardia (pulse) > (mean for age) + (1 SD)	2
	bradycardia (pulse) < (mean for age) – (1 SD)	1
	0	0
respiratory rate	normal (mean for age) +/- (1 SD)	3
	tachypnea (respiratory rate) > (mean for age) + (1 SD)	2
	hypoventilation (respiratory rate) < (mean for age) – (1 SD)	1
	0	0
	intubated	0

where:

• I would have thought that mild hypotension would be (blood pressure) – (1 SD) to (blood pressure) – (2 SD).

• There is no scoring for hypertension.

Age	Systolic Blood Pressure in mm Hg		Pulse		Respiratory Rate
	M - 2 SD	M - 3 SD	M + 1 SD	M - 1 SD	M + 1 SD	M - 1 SD
0	60	35	180	120	45	19
0.5	65	40	170	115	41	17
1	70	44	165	110	37	15
2	77	57	150	100	34	14
3	76	54	145	95	33	15
4	82	65	140	92	33	15
5	80	60	132	90	30	16
6	83	65	130	88	28	16
7	82	63	126	88	28	14
8	86	68	124	86	28	14
9	88	72	120	84	28	14
10	88	70	120	80	28	14
11	90	72	120	78	28	14
12	90	70	120	76	28	14
13	90	70	120	76	28	14
14	90	70	120	76	28	14
15	90	70	120	76	26	12
16	90	70	120	76	26	12

extracted from plots in Figure 1, page 108

total ASPTS =

= SUM(points for all 4 parameters)

Interpretation:

• minimum score: 0

• maximum score: 12

• The higher the score, the better the prognosis.

Score	Probability of Mortality	Probability ISS > 20
12	0%	5%
11	0%	19.9%
10	0.3%	8.8%
9	5.4%	36.6%
8	9.3%	41%
7	11.4%	54.5%
6	20.6%	55.4%
5	28.3%	58.6%
4	55%	72.5%
3	83.4%	67.7%
2	100%	57.1%
1	100%	62.5%
0	100%	63.8%

from Table 3, page 108

Performance:

• Using a total ASPTS < 10 as the indicator for mortality, the sensitivity for mortality is 97% and specificity is 89%.

• Using a total ASPTS < 8 as the indicator for mortality, the sensitivity for mortality is 91% and specificity is 94%.

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The Age-Specific Pediatric Trauma Score (ASPTS) of Potoka et al

Description

Specialty