Development of a novel age-specific pediatric trauma score

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.