Comparative Evaluation of Shock Index Pediatric Age Adjusted and Pediatric Trauma Score in Predicting Morbidity in Pediatric Abdominal Trauma: A Prospective Single-center Study

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Abstract
A BSTRACT: Aim: This study aims to compare the pediatric trauma score (PTS) and shock index pediatric age adjusted (SIPA) score for predicting the outcome in children presenting with trauma mainly abdomen. Methodology: Prospective study of 18 months with recruitment of trauma patients admitted to a tertiary centre with mainly abdominal trauma. After immediate resuscitation, SIPA and PTS scores were computed and reassessed 24 h later. The outcomes of injured subjects were analyzed using an indigenous morbidity scoring system and compared with SIPA and PTS scores. Statistical methods were used for demographic details, uni/multivariate analysis, and for calculating predictive values. Results: Male (aged 5–8 years) was identified as most commonly injured. Fall was noted as most frequent mechanism and maximally contributed to high morbidity. Liver was most frequently injured, whereas hollow viscous injuries (pneumoperitoneum) were associated with the poorest outcome. SIPA and PTS, both at admission and 24 h later, significantly correlated with morbidity, with 82% predictive accuracy ( P < 0.001 for SIPA; P = 0.003 for PTS). This association weakened at 24 h with normalization of SIPA after resuscitation in 70% of cases, whereas PTS maintained uniformity with consistency across 24 h. Multivariate regression analysis identified that among significant factors, pneumoperitoneum, low PTS, and infant subjects had the highest odds ratios for poor outcome following trauma to the abdomen. Conclusion: Pediatric trauma victims with abdominal injuries can be triaged using SIPA soon after injury, whereas for delayed presenters, PTS is a better alternative, albeit with suggested age-based value correction for its components.

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