Prognostic value of trauma scores in pediatric patients with multiple injuries

Background: For the quantification of multiple injuries in children, a rang e of different trauma scores are available, the actual prognostic value of which has, however, not so far been investigated and compared in a group of patients. Methods: In 261 polytraumatized children and adolescents, 11 trauma scores (Abbreviated Injury Scale [AIS], Injury Severity Score[ISS], Glasgow Coma S cale [GCS], Acute Trauma Index [ATI], Shock Index [SI], Trauma Score [TS], Revised Trauma Score [RTS], Modified Injury Severity Score [MISS], Trauma a nd Injury Severity Score [TRISS]-Scan, Hannover Polytrauma Score [HPTS], an d Pediatric Trauma Score [PTS]) were calculated, and their prognostic relev ance in terms of survival, duration of intensive care treatment, hospital s tay, and long-term outcome analyzed. Results: With a specificity of 80%, physiologic scores (TS, RTS, GCS, ATI) showed a greater accuracy (79-86% vs. 73-79%) with regard to survival predi ction than did the anatomic scores (AIS, HPTS, ISS, PTS); combined forms of these two types of score (TRISS-Scan, MISS) did not provide any additional information (76-80%). Overall, the TRISS-Scan was the score that showed th e highest correlation with duration of treatment and long-term outcome. Tra uma scores specially conceived for use with children (PTS, MISS) failed to show any superiority vis-g-vis trauma scores in general. Conclusion: With regard to prognostic quality and ease of use in the practi cal setting, TS and the TRISS-Scan are recommended for polytrauma in childr en and adolescents. Special pediatric scores are not necessary.