The prognostic importance of trauma scoring systems for morbidity in children with penetrating abdominal wounds: 17 years of experience.
OBJECTIVE
Risk factors that may independently predict morbidity in children with penetrating abdominal wounds (PAW) have not been elucidated fully. The aim of this study was to identify not only correlated risk factors for morbidity in children with PAW, but also to evaluate the independent predictive value of 3 different trauma scoring systems: the Injury Severity Score (ISS), the Penetrating Abdominal Trauma Index (PATI), and the Pediatric Trauma Score (PTS).


METHODS
Between January 1983 and November 2000, 119 children (99 boys, 20 girls) presenting with PAW were reevaluated by an analysis of the relationship between overall morbidity and potential risk factors.


RESULTS
Wounds were caused by firearm trauma in 85 children and stabbing in 34. Univariate analysis found that age greater than 10 years, trauma mechanism, number of intraabdominal organs injured (NOI) greater than 2, presence of penetrating injury, and ISS and PATI score were associated with greater than 3-fold increased incidence of morbidity (P <.05). The relative risk of a postoperative septic complication was higher than 2 for the following risk factors: age greater than 10 years, shotgun injury, number of organs injured greater than 2, presence of colon injury, ISS greater than 15, and PATI score greater than 15. Multivariate analysis showed that only ISS (P =.02), and PATI score (P =.03) were independently significant in predicting morbidity.


CONCLUSIONS
ISS and PATI score were the most important indicators found to be independently associated with morbidity.
öztürk
Hayrettin
H
Department of Pediatric Surgery, Dicle University Medical School, Diyarbakir, Turkey.
Dokucu
Ali Ihsan
AI
Otcu
Selcuk
S
Onen
Abdurrahman
A
D000007:Abdominal Injuries / Q000145:classification* / Q000150:complications / Q000601:surgery; D000293:Adolescent; D000367:Age Factors; D000704:Analysis of Variance; D001753:Blast Injuries / Q000145:classification / Q000150:complications / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007239:Infections / Q000209:etiology; D007902:Length of Stay; D008297:Male; D009104:Multiple Trauma / Q000209:etiology; D011183:Postoperative Complications / Q000209:etiology; D011379:Prognosis; D012307:Risk Factors; D015599:Trauma Severity Indices; D014948:Wounds, Gunshot / Q000145:classification / Q000150:complications / Q000601:surgery; D014950:Wounds, Penetrating / Q000145:classification* / Q000150:complications / Q000601:surgery; D014951:Wounds, Stab / Q000145:classification / Q000150:complications / Q000601:surgery