Vallipakorn et al developed a score for evaluating pediatric patients suffering trauma. This can help to identify a patient who may benefit from more aggressive management. The authors are from Ramathibodi Hospital, Mahidol University, Child Safety Promotion and Injury Prevention Research Center in Bangkok, Thailand.
Patient selection: pediatric trauma patient in Thailand
Outcome: mortality
Parameters:
(2) airway
(3) physical mechanism
(4) head and neck injury
(5) thoracic injury
(6) abdomen-pelvis injury
(7) Glasgow coma score (GCS)
(8) pulse rate
(9) respiratory rate
(10) systolic blood pressure
|
Parameter |
Finding |
Points |
|
age |
<= 5 years of age |
0.65 |
|
|
6 to 12 years |
1.09 |
|
|
>= 13 years |
0 |
|
airway |
intubation |
2.39 |
|
|
adjunct |
1.21 |
|
|
no intervention |
0 |
|
physical mechanism |
pure velocity |
0.24 |
|
|
pure gravity |
0.71 |
|
|
mixed |
0.36 |
|
|
neither |
0 |
|
head and neck injury |
yes |
1.61 |
|
|
no |
0 |
|
thoracic injury |
yes |
1.52 |
|
|
no |
0 |
|
abdomen-pelvis injury |
yes |
1.62 |
|
|
no |
0 |
|
Glasgow Coma Score |
<9 |
1.40 |
|
|
>= 9 |
0 |
|
pulse |
bradycardia |
2.42 |
|
|
tachycardia |
0.80 |
|
|
normal |
0 |
|
respiratory rate |
abnormal |
0.79 |
|
|
normal |
0 |
|
systolic blood pressure |
abnormal |
1.61 |
|
|
normal |
0 |
total score =
= SUM(points for 10 parameters)
Interpretation:
• minimum score: 0
• maximum score: 15.16
• The higher the score the greater the risk of mortality.
|
Score |
Mortality Risk |
|
< 1.02 |
very low |
|
1.02 to 1.95 |
low |
|
1.96 to 3.05 |
intermediate |
|
>= 3.06 |
high |
Performance:
• The area under the ROC curve is 0.94.
Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general, Pedatrics
