Background/Purpose: Trauma scoring systems are needed to provide efficient
triage of injured patients and to assess differences in outcomes and qualit
y of care between different trauma centers. Current scoring systems used in
pediatric trauma are not age specific, and thus have significant limitatio
ns.
Methods: The authors queried The Pennsylvania Trauma Outcome Study for all
children 0 to 16 years entered in the database from 1993 to 1996. Age-speci
fic threshold values for systolic blood pressure, pulse, and respiratory Fa
te were established. Using coded scores for these age-specific values and G
lasgow Coma Scale, an age-specific pediatric trauma score (ASPTS) was deriv
ed. Triage ASPTS (T-ASPTS) consisted of the integer sum of coded scores for
the 4 variables, whereas ASPTS was calculated using weighted coefficients
derived from logistic regression for each variable.
Results: T-ASPTS correlated with mortality rate. Using a threshold score of
less than 10, T-ASPTS predicted mortality rate with a sensitivity of 96.97
% and a specificity of 88.83%. T-ASPTS predicted mortality rate and percent
age of patients with Injury Severity Score greater than 20 with similar sen
sitivity to the Revised Trauma Score (RTS), but T-ASPTS was more specific.
The ASPTS predicted probability of survival more accurately than the RTS.
Conclusions: ASPTS performs favorably as both a triage score and as a tool
for predicting probability of survival for outcomes analysis, Further compa
risons to existing trauma scores are needed to verify the utility of ASPTS,
J Pediatr Surg 36:106-112. Copyright (C) 2001 by W.B. Saunders Company.