Abstract
Background/purpose: Resource-based severity of injury (SOI) measures, such as the International Classification of Disease (ICD) Critical Care Severity Score (ICASS), may characterize traumatic burden better than standard mortality-based measures. The purpose of this study was to validate the ICASS in a representative national-level trauma cohort and compare SOI measures between children and adults. Methods: The National Trauma Databank was used to derive (2008–12) and validate (2013–15) ICASS and ICD Injury Severity Scores (ICISS, standard mortality-based SOI measure). SOI metrics and outcomes were compared between pediatric, adult, and elderly age groups. Logistic regression modeling evaluated predictors of critical care resource utilization. Results: Derivation and validation cohorts consisted of 3.90 and 1.97 million patients, respectively. ICASS strongly predicted actual critical care utilization (OR 1.04, 95% CI 1.04–1.04, p<0.0001). Mean ICASS was 24.4 for children and 33.0 for adults (ratio 0.74), indicating predicted critical care utilization in children was three-quarters that of adults. In contrast, predicted pediatric mortality was less than half that of adults. Conclusions: Mortality-based SOI measures underestimate pediatric burden of injury. This study validates ICASS and demonstrates that pediatric resource-based SOI is more similar to that of adults. ICASS is easily calculated without a trauma registry and complements mortality-based measures.
Original language | English (US) |
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Pages (from-to) | 1354-1357 |
Number of pages | 4 |
Journal | Journal of pediatric surgery |
Volume | 57 |
Issue number | 7 |
DOIs | |
State | Published - Jul 2022 |
Keywords
- Injury severity
- Mortality
- Outcomes
- Pediatric trauma
- Resource utilization
- Trauma metrics
ASJC Scopus subject areas
- Surgery
- Pediatrics, Perinatology, and Child Health