Prognostic value of trauma scores in pediatric patients with multiple injuries.
BACKGROUND
For the quantification of multiple injuries in children, a range of different trauma scores are available, the actual prognostic value of which has, however, not so far been investigated and compared in a group of patients.


METHODS
In 261 polytraumatized children and adolescents, 11 trauma scores (Abbreviated Injury Scale [AIS], Injury Severity Score [ISS], Glasgow Coma Scale [GCS], Acute Trauma Index [ATI], Shock Index [SI], Trauma Score [TS], Revised Trauma Score [RTS], Modified Injury Severity Score [MISS], Trauma and Injury Severity Score [TRISS]-Scan, Hannover Polytrauma Score [HPTS], and Pediatric Trauma Score [PTS]) were calculated, and their prognostic relevance in terms of survival, duration of intensive care treatment, hospital stay, and long-term outcome analyzed.


RESULTS
With a specificity of 80%, physiologic scores (TS, RTS, GCS, ATI) showed a greater accuracy (79-86% vs. 73-79%) with regard to survival prediction than did the anatomic scores (AIS, HPTS, ISS, PTS); combined forms of these two types of score (TRISS-Scan, MISS) did not provide any additional information (76-80%). Overall, the TRISS-Scan was the score that showed the highest correlation with duration of treatment and long-term outcome. Trauma scores specially conceived for use with children (PTS, MISS) failed to show any superiority vis-à-vis trauma scores in general.


CONCLUSIONS
With regard to prognostic quality and ease of use in the practical setting, TS and the TRISS-Scan are recommended for polytrauma in children and adolescents. Special pediatric scores are not necessary.
Ott
R
R
Department of Surgery, University of Erlangen-Nuremberg, Germany.
Krämer
R
R
Martus
P
P
Bussenius-Kammerer
M
M
Carbon
R
R
Rupprecht
H
H
D000293:Adolescent; D017677:Age Distribution; D000367:Age Factors; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D009104:Multiple Trauma / Q000175:diagnosis* / Q000401:mortality; D011379:Prognosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D015996:Survival Rate; D015599:Trauma Severity Indices; D016896:Treatment Outcome