Abstract
Objectives: Injury severity scoring tools allow systematic comparison of outcomes in trauma research and quality improvement by indexing an expected mortality risk for certain injuries. This study investigated the predictive value of the empirically derived ICD9-derived Injury Severity Score (ICISS) compared to expert consensus-derived scoring systems for trauma mortality in a pediatric population. Methods: 1935 consecutive trauma patients aged <18 years from 1/2000 to 12/2012 were reviewed. Mechanism of injury (MOI), Injury Severity Score (ISS), Revised Trauma Score (RTS), Trauma Score ISS (TRISS), and ICISS were compared using univariate and multivariate logistic regression analysis and receiver operator characteristic analysis. Results: The population was a median age of 11 ± 6 year, 70 % male, and 76 % blunt injury. Median ISS 13 ± 12 and overall mortality 3.5 %. Independent predictors of mortality were initial hematocrit [odds ratio (OR) 0.83 (0.73–0.95)], HCO3 [OR 0.82 (0.67–0.98)], Glasgow Coma Scale score [OR 0.75 (0.62–0.90)], and ISS [OR 1.10 (1.04–1.15)]. TRISS was superior to ICISS in predicting survival [area under receiver operator curve: 0.992 (0.982–1.000) vs 0.888 (0.838–0.938)]. Conclusions: ICISS was inferior to existing injury scoring tools at predicting mortality in pediatric trauma patients.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 657-663 |
| Number of pages | 7 |
| Journal | Pediatric Surgery International |
| Volume | 32 |
| Issue number | 7 |
| DOIs | |
| State | Published - Jul 1 2016 |
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Keywords
- Children
- ICISS
- Injury
- Mortality
- Pediatric Trauma
- Survival
- Trauma outcomes
- TRISS
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Surgery
Cite this
Predictors of mortality in pediatric trauma : experiences of a level 1 trauma center and an assessment of the International Classification Injury Severity Score (ICISS). / Allen, Casey J.; Wagenaar, Amy E.; Horkan, Davis B.; Baldor, Daniel J.; Hannay, William M.; Tashiro, Jun; Namias, Nicholas; Sola, Juan E.
In: Pediatric Surgery International, Vol. 32, No. 7, 01.07.2016, p. 657-663.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Predictors of mortality in pediatric trauma
T2 - experiences of a level 1 trauma center and an assessment of the International Classification Injury Severity Score (ICISS)
AU - Allen, Casey J.
AU - Wagenaar, Amy E.
AU - Horkan, Davis B.
AU - Baldor, Daniel J.
AU - Hannay, William M.
AU - Tashiro, Jun
AU - Namias, Nicholas
AU - Sola, Juan E
PY - 2016/7/1
Y1 - 2016/7/1
N2 - Objectives: Injury severity scoring tools allow systematic comparison of outcomes in trauma research and quality improvement by indexing an expected mortality risk for certain injuries. This study investigated the predictive value of the empirically derived ICD9-derived Injury Severity Score (ICISS) compared to expert consensus-derived scoring systems for trauma mortality in a pediatric population. Methods: 1935 consecutive trauma patients aged <18 years from 1/2000 to 12/2012 were reviewed. Mechanism of injury (MOI), Injury Severity Score (ISS), Revised Trauma Score (RTS), Trauma Score ISS (TRISS), and ICISS were compared using univariate and multivariate logistic regression analysis and receiver operator characteristic analysis. Results: The population was a median age of 11 ± 6 year, 70 % male, and 76 % blunt injury. Median ISS 13 ± 12 and overall mortality 3.5 %. Independent predictors of mortality were initial hematocrit [odds ratio (OR) 0.83 (0.73–0.95)], HCO3 [OR 0.82 (0.67–0.98)], Glasgow Coma Scale score [OR 0.75 (0.62–0.90)], and ISS [OR 1.10 (1.04–1.15)]. TRISS was superior to ICISS in predicting survival [area under receiver operator curve: 0.992 (0.982–1.000) vs 0.888 (0.838–0.938)]. Conclusions: ICISS was inferior to existing injury scoring tools at predicting mortality in pediatric trauma patients.
AB - Objectives: Injury severity scoring tools allow systematic comparison of outcomes in trauma research and quality improvement by indexing an expected mortality risk for certain injuries. This study investigated the predictive value of the empirically derived ICD9-derived Injury Severity Score (ICISS) compared to expert consensus-derived scoring systems for trauma mortality in a pediatric population. Methods: 1935 consecutive trauma patients aged <18 years from 1/2000 to 12/2012 were reviewed. Mechanism of injury (MOI), Injury Severity Score (ISS), Revised Trauma Score (RTS), Trauma Score ISS (TRISS), and ICISS were compared using univariate and multivariate logistic regression analysis and receiver operator characteristic analysis. Results: The population was a median age of 11 ± 6 year, 70 % male, and 76 % blunt injury. Median ISS 13 ± 12 and overall mortality 3.5 %. Independent predictors of mortality were initial hematocrit [odds ratio (OR) 0.83 (0.73–0.95)], HCO3 [OR 0.82 (0.67–0.98)], Glasgow Coma Scale score [OR 0.75 (0.62–0.90)], and ISS [OR 1.10 (1.04–1.15)]. TRISS was superior to ICISS in predicting survival [area under receiver operator curve: 0.992 (0.982–1.000) vs 0.888 (0.838–0.938)]. Conclusions: ICISS was inferior to existing injury scoring tools at predicting mortality in pediatric trauma patients.
KW - Children
KW - ICISS
KW - Injury
KW - Mortality
KW - Pediatric Trauma
KW - Survival
KW - Trauma outcomes
KW - TRISS
UR - http://www.scopus.com/inward/record.url?scp=84973121378&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84973121378&partnerID=8YFLogxK
U2 - 10.1007/s00383-016-3900-7
DO - 10.1007/s00383-016-3900-7
M3 - Article
C2 - 27255740
AN - SCOPUS:84973121378
VL - 32
SP - 657
EP - 663
JO - Pediatric Surgery International
JF - Pediatric Surgery International
SN - 0179-0358
IS - 7
ER -