Comparing Pediatric Trauma, Glasgow Coma Scale and Injury Severity scores for mortality prediction in traumatic children.
BACKGROUND
Trauma is a major cause of disability and death among children worldwide, particularly in developed countries. The present aim was to compare efficacies of the Pediatric Trauma score (PTS), the Glasgow Coma Scale score (GCS), and the Injury Severity Score (ISS) in the prediction of mortality in children injured by trauma.


METHODS
A total of 588 children admitted to the emergency ward of the Poursina Medical and Educational Center from 2010-2011 with trauma were included. The PTS, GCS, and ISS were calculated for all patients. Predictive efficacy of these scores was compared using receiver operating characteristic (ROC) curve with 95% confidence interval.


RESULTS
Of the patient population, 62.1% were male and 37.9% female, with a mean age of 7.31±3.8 years. Road accident (42.2%) was the most common cause of injury. Overall, 2.4% of participants died. Regarding the prediction of mortality, the best cut-off point for the GCS was ≤8, with 98.4% sensitivity and 92.3% specificity. The same point for the PTS was ≤0.5, with 100% sensitivity and 31% specificity. For the ISS it was ≥16.5, with 92.5% sensitivity and 62% specificity. All variables based on mortality prediction were statistically significant (p<0.0001).


CONCLUSIONS
When compared to the PTS and ISS, the GCS may be a better predictor of mortality in cases of childhood trauma.
Preventive and Social Medicine, Medical Faculty, Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht-Iran.
Shahrokh
S
Yousefzadeh-Chabok
Preventive and Social Medicine, Medical Faculty, Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht-Iran.
Ehsan
E
Kazemnejad-Leili
Preventive and Social Medicine, Medical Faculty, Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht-Iran.
Leila
L
Kouchakinejad-Eramsadati
Preventive and Social Medicine, Medical Faculty, Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht-Iran.
Marieh
M
Hosseinpour
Preventive and Social Medicine, Medical Faculty, Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht-Iran.
Fatemeh
F
Ranjbar
Preventive and Social Medicine, Medical Faculty, Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht-Iran.
Reza
R
Malekpouri
Preventive and Social Medicine, Medical Faculty, Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht-Iran. mohtashamaz@yahoo.com.
Zahra
Z
Mohtasham-Amiri
D000059:Accidents; D000293:Adolescent; D002648:Child; D002662:Child Health Services; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000401:mortality* / Q000473:pathology; D005260:Female; D015600:Glasgow Coma Scale; D017052:Hospital Mortality; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D015601:Injury Severity Score; D008297:Male; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity; D014421:Turkey