大比分,包括准入基数赤字(B),国际标准化比率(I),和GCS(G),是一种疾病严重程度评分,可用于快速预测外伤后出现的儿科患者的院内死亡率。我们试图将儿科创伤BIG评分的死亡率预测与其他公认的儿科创伤疾病严重程度评分进行比较:儿科逻辑器官功能障碍(PELOD);儿科死亡率指数2(PIM2);和儿科死亡率风险(PRISMIII)。
在这项回顾性队列研究中,2009年至2015年的数据是使用多机构数据库收集的.包括所有记录有初始GCS的外伤后入院的儿科患者。BIG,PELOD,计算PIM2和PRISMIII评分,得出所有疾病严重程度评分的受试者操作员特征曲线。通过曲线下面积(AUC)比较每个分数的死亡率预测性能。
共有29,204名患者被纳入该分析。AUC为BIG,PELOD,PIM2和PRISMIII评分为0.97(0.97-0.98),0.98(0.98-0.98),0.98(0.97-0.98),和0.99(0.98-0.99),分别。在16的最佳截止点,BIG评分的灵敏度为0.937,特异性为0.938,阳性预测值为0.514,阴性预测值为0.995。
在这个庞大的儿科创伤患者队列中,使用缺失变量的填补的BIG得分与PELOD类似,PIM2和PRISMIII,进一步验证分数作为死亡率的预测指标。
The BIG score, which is comprised of admission base deficit (B), International Normalized Ratio (I), and GCS (G), is a severity of illness score that can be used to rapidly predict in-hospital mortality in pediatric patients presenting following traumatic injury. We sought to compare the mortality prediction of the pediatric trauma BIG score with other well-established pediatric trauma severity of illness scores: the pediatric logistic organ dysfunction (PELOD); the pediatric index of mortality 2 (PIM2); and the pediatric risk of mortality (PRISM III).
In this retrospective cohort study, data from 2009 to 2015 was collected using a multi-institutional database. All pediatric patients admitted following traumatic injury with a recorded initial GCS were included. BIG, PELOD, PIM2, and PRISM III scores were calculated, and Receiver Operator Characteristic curves were derived for all severity of illness scores. Mortality prediction performance for each score was compared by the area under the curve (AUC).
A total of 29,204 patients were included in this analysis. AUC for BIG, PELOD, PIM2, and PRISM III scores were 0.97 (0.97-0.98), 0.98 (0.98-0.98), 0.98 (0.97-0.98), and 0.99 (0.98-0.99), respectively. At the optimum cut-off point of 16, the BIG score had a sensitivity of 0.937, specificity of 0.938, positive predictive value of 0.514, and negative predictive value of 0.995.
In this massive cohort of pediatric trauma patients, the BIG score using imputation of missing variables performed similarly to the PELOD, PIM2, and PRISM III, further validating the score as a predictor of mortality.