Abstract
We have previously demonstrated that a shock index, pediatric age adjusted (SIPA) accurately identifies severely blunt injured children. We aimed to determine if SIPA could more accurately identify children with severe traumatic brain injury (TBI) than hypotension alone. We performed subset analysis of those children with TBI among a cohort of children age 4-16 years with blunt trauma and injury severity score ≥15 from 1/07 to 6/13. We evaluated the ability of four markers to identify the most severely brain injured children. Markers included hypotension, elevated SIPA, abnormal GCS motor score (GMS), and elevated SIPA or abnormal GMS. We aimed to determine which of these four markers had the highest sensitivity in identifying severely injured children. Three hundred and ninety-two (392) children were included. Hypotension was present in 24 patients (6%); elevated SIPA in 106 (27 %), abnormal GMS in 172 (44%), and elevated SIPA or abnormal GMS in 206 (53%). All markers were able to accurately identify severely injured children with TBI. Elevated SIPA or abnormal GMS identified a greater percentage of patients with each of seven complications with higher sensitivity than each of the three other markers. Among blunt injured child...Continue Reading
References
Feb 1, 1992·The Journal of Pediatrics·M W Lieh-LaiA I Canady
Feb 1, 1993·The Journal of Trauma·R M ChesnutM A Foulkes
Mar 1, 1993·Journal of Pediatric Surgery·F A PigulaD W Vane
Mar 14, 1998·Journal of Pediatric Surgery·E R KokoskaT R Weber
Dec 17, 2003·The Journal of Trauma·Monica S VavilalaFrederick P Rivara
Aug 3, 2006·Pediatrics·Andrew J SchneierGary A Smith
Jan 24, 2008·The Journal of Trauma·Mark FaulRichard W Sattin
Dec 17, 2009·The Journal of Trauma·Chad M CannonMichael Moncure
Jul 14, 2010·The Journal of Trauma·Robert D BarracoUNKNOWN EAST Practice Management Guidelines Work Group
Jul 24, 2010·Neurocritical Care·Joshua Kornbluth, Anish Bhardwaj
Feb 11, 2011·The Journal of Trauma·Marianne J VandrommeJordan A Weinberg
May 23, 2013·The Journal of Trauma and Acute Care Surgery·Stevan R BruijnsWallis A Lee
Mar 26, 2014·The Journal of Trauma and Acute Care Surgery·Shannon N AckerDenis D Bensard
Jul 25, 2014·The Journal of Trauma and Acute Care Surgery·Shannon N AckerDenis D Bensard
Feb 2, 2015·Journal of Pediatric Surgery·Shannon N AckerDenis D Bensard
Citations
Oct 9, 2016·Journal of Pediatric Surgery·Maria E LinnausRobert W Letton
May 21, 2016·Shock·Samiran RayMark J Peters
Mar 21, 2019·Pediatric Surgery International·Robert J VandewalleThomas M Rouse
Jan 22, 2020·Prehospital Emergency Care : Official Journal of the National Association of EMS Physicians and the National Association of State EMS Directors·Geet GandhiBlake Bulloch
Mar 5, 2018·BMJ Open·Tetsuya YumotoAtsunori Nakao
Mar 17, 2020·The Journal of Trauma and Acute Care Surgery·Christopher W MarencoMatthew J Eckert
Sep 11, 2019·World Neurosurgery·Ayman El-MenyarHassan Al-Thani
Jul 10, 2021·Injury·Emily C AlbertoRandall S Burd
Oct 26, 2021·The Journal of Trauma and Acute Care Surgery·Marina L ReppucciDenis Bensard