Back to Search
Start Over
Evaluation of activation criteria in paediatric multi-trauma.
- Source :
-
Paediatrics & Child Health (1205-7088) . Feb2023, Vol. 28 Issue 1, p17-23. 7p. - Publication Year :
- 2023
-
Abstract
- Objective To explore the optimal set of trauma activation criteria predicting paediatric patients' need for acute care following multi-trauma, with particular attention to Glasgow Coma Scale (GCS) cut-off value. Methods A retrospective cohort study of paediatric multi-trauma patients aged 0 to 16 years, performed at a Level 1 paediatric trauma centre. Trauma activation criteria and GCS levels were examined with respect to patients' need for acute care, defined as: direct to operating room disposition, intensive care unit admission, need for acute interventions in the trauma room, or in-hospital death. Results We enrolled 436 patients (median age 8.0 years). The following predicted need for acute care: GCS <14 (adjusted odds ratio [aOR] 23.0, 95% confidence interval [CI]: 11.5 to 45.9, P < 0.001), hemodynamic instability: (aOR 3.7, 95% CI: 1.2-8.1, P = 0.01), open pneumothorax/flail chest (aOR: 20.0, 95% CI: 4.0 to 98.7, P < 0.001), spinal cord injury (aOR 15.4, 95% CI; 2.4 to 97.1, P = 0.003), blood transfusion at the referring hospital (aOR: 7.7, 95% CI: 1.3 to 44.2, P = 0.02) and GSW to the chest, abdomen, neck, or proximal extremities (aOR 11.0, 95% CI; 1.7 to 70.8, P = 0.01). Using these activation criteria would have decreased over- triage by 10.7%, from 49.1% to 37.2% and under-triage by 1.3%, from 4.7% to 3.5%, in our cohort of patients. Conclusions Using GCS<14, hemodynamic instability, open pneumothorax/flail chest, spinal cord injury, blood transfusion at the referring hospital, and GSW to the chest, abdomen, neck of proximal extremities, as T1 activation criteria could decrease over- and under-triage rates. Prospective studies are needed to validate the optimal set of activation criteria in paediatric patients. [ABSTRACT FROM AUTHOR]
- Subjects :
- *OPERATING rooms
*INTENSIVE care units
*CONFIDENCE intervals
*SPINAL cord injuries
*MEDICAL triage
*TRAUMA centers
*FLAIL chest
*BLOOD transfusion
*PEDIATRICS
*RETROSPECTIVE studies
*HOSPITAL mortality
*GLASGOW Coma Scale
*CRITICAL care medicine
*DESCRIPTIVE statistics
*WOUNDS & injuries
*NEEDS assessment
*ODDS ratio
*HEMODYNAMICS
*DATA analysis software
*MEDICAL needs assessment
*LONGITUDINAL method
*PNEUMOTHORAX
Subjects
Details
- Language :
- English
- ISSN :
- 12057088
- Volume :
- 28
- Issue :
- 1
- Database :
- Academic Search Index
- Journal :
- Paediatrics & Child Health (1205-7088)
- Publication Type :
- Academic Journal
- Accession number :
- 162393895
- Full Text :
- https://doi.org/10.1093/pch/pxac085