Applicability of the revised trauma score in paediatric patients admitted to a South African intensive care unit: A retrospective cohort study
Context: Revised Trauma Score (RTS) is a validated tool in assessing patients in a pre-hospital setting. There are limited data describing its potential use in guiding referral to intensive care. Aims: Trauma scoring systems require appropriate validation in a local setting before effective applicat...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2021-01-01
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| Series: | African Journal of Paediatric Surgery |
| Subjects: | |
| Online Access: | http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2021;volume=18;issue=3;spage=150;epage=154;aulast=Kuronen-Stewart |
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| author | Cameron Kuronen-Stewart Nirav Patel Tarryn Gabler Isabel Khofi-Phiri Gladness Dakalo Nethathe Jerome Loveland |
| author_facet | Cameron Kuronen-Stewart Nirav Patel Tarryn Gabler Isabel Khofi-Phiri Gladness Dakalo Nethathe Jerome Loveland |
| author_sort | Cameron Kuronen-Stewart |
| collection | DOAJ |
| description | Context: Revised Trauma Score (RTS) is a validated tool in assessing patients in a pre-hospital setting. There are limited data describing its potential use in guiding referral to intensive care. Aims: Trauma scoring systems require appropriate validation in a local setting before effective application. This work examines the applicability of RTS to a paediatric intensive care trauma population. Settings and Design: A retrospective record review of trauma patients admitted to the paediatric intensive care unit at Chris Hani Baragwanath Academic Hospital between 2011 and 2013 was performed. Subjects and Methods: The cohort was arbitrarily split into three subgroups based on RTS using the 33rd and 66th percentile values and groups compared. Outcome measures examined included mortality, age, gender, length of stay (LoS), duration of ventilation (DoV) and change in Glasgow Coma Scale (GCS) from admission to discharge. Statistical Analysis Used: Categorical values examined with Fisher's exact test. Non-categorical values examined with the Kruskal–Wallis and Dunn's multiple comparisons tests. Results: Of 919 children admitted, 165 admissions were secondary to trauma. Data necessary for calculation of RTS were available in 91 patients. The mean RTS was 5.3, 33rd percentile was 4.7 and 66th was 5.9. DoV (P = 0.0104) and LoS (P = 0.0395) were significantly different between intermediate- and low-risk groups as was change in GCS between low-risk and both other groups (P < 0.0001). Conclusions: RTS is not predictive of mortality between high-risk (RTS < 4.09) and low-risk patients (RTS > 5.67) in this population. It may be useful in predicting other outcomes such as DoV and LoS. |
| first_indexed | 2024-12-17T21:52:17Z |
| format | Article |
| id | doaj.art-6545feecb37043f4a6a9cc5a2ef9a168 |
| institution | Directory Open Access Journal |
| issn | 0189-6725 |
| language | English |
| last_indexed | 2024-12-17T21:52:17Z |
| publishDate | 2021-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | African Journal of Paediatric Surgery |
| spelling | doaj.art-6545feecb37043f4a6a9cc5a2ef9a1682022-12-21T21:31:14ZengWolters Kluwer Medknow PublicationsAfrican Journal of Paediatric Surgery0189-67252021-01-0118315015410.4103/ajps.AJPS_33_20Applicability of the revised trauma score in paediatric patients admitted to a South African intensive care unit: A retrospective cohort studyCameron Kuronen-StewartNirav PatelTarryn GablerIsabel Khofi-PhiriGladness Dakalo NethatheJerome LovelandContext: Revised Trauma Score (RTS) is a validated tool in assessing patients in a pre-hospital setting. There are limited data describing its potential use in guiding referral to intensive care. Aims: Trauma scoring systems require appropriate validation in a local setting before effective application. This work examines the applicability of RTS to a paediatric intensive care trauma population. Settings and Design: A retrospective record review of trauma patients admitted to the paediatric intensive care unit at Chris Hani Baragwanath Academic Hospital between 2011 and 2013 was performed. Subjects and Methods: The cohort was arbitrarily split into three subgroups based on RTS using the 33rd and 66th percentile values and groups compared. Outcome measures examined included mortality, age, gender, length of stay (LoS), duration of ventilation (DoV) and change in Glasgow Coma Scale (GCS) from admission to discharge. Statistical Analysis Used: Categorical values examined with Fisher's exact test. Non-categorical values examined with the Kruskal–Wallis and Dunn's multiple comparisons tests. Results: Of 919 children admitted, 165 admissions were secondary to trauma. Data necessary for calculation of RTS were available in 91 patients. The mean RTS was 5.3, 33rd percentile was 4.7 and 66th was 5.9. DoV (P = 0.0104) and LoS (P = 0.0395) were significantly different between intermediate- and low-risk groups as was change in GCS between low-risk and both other groups (P < 0.0001). Conclusions: RTS is not predictive of mortality between high-risk (RTS < 4.09) and low-risk patients (RTS > 5.67) in this population. It may be useful in predicting other outcomes such as DoV and LoS.http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2021;volume=18;issue=3;spage=150;epage=154;aulast=Kuronen-Stewartpaediatric surgerypaediatric traumarevised trauma scoresouth africa |
| spellingShingle | Cameron Kuronen-Stewart Nirav Patel Tarryn Gabler Isabel Khofi-Phiri Gladness Dakalo Nethathe Jerome Loveland Applicability of the revised trauma score in paediatric patients admitted to a South African intensive care unit: A retrospective cohort study African Journal of Paediatric Surgery paediatric surgery paediatric trauma revised trauma score south africa |
| title | Applicability of the revised trauma score in paediatric patients admitted to a South African intensive care unit: A retrospective cohort study |
| title_full | Applicability of the revised trauma score in paediatric patients admitted to a South African intensive care unit: A retrospective cohort study |
| title_fullStr | Applicability of the revised trauma score in paediatric patients admitted to a South African intensive care unit: A retrospective cohort study |
| title_full_unstemmed | Applicability of the revised trauma score in paediatric patients admitted to a South African intensive care unit: A retrospective cohort study |
| title_short | Applicability of the revised trauma score in paediatric patients admitted to a South African intensive care unit: A retrospective cohort study |
| title_sort | applicability of the revised trauma score in paediatric patients admitted to a south african intensive care unit a retrospective cohort study |
| topic | paediatric surgery paediatric trauma revised trauma score south africa |
| url | http://www.afrjpaedsurg.org/article.asp?issn=0189-6725;year=2021;volume=18;issue=3;spage=150;epage=154;aulast=Kuronen-Stewart |
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