Scoring of pediatric orthopaedic polytrauma: correlations of different injury scoring systems and prognosis for hospital course

Abstract

Trauma scoring systems were compared among themselves and to recovery variables in a cohort of 91 pediatric polytrauma patients with orthopaedic injuries. They included the Trauma Score (TS), Revised Trauma Score (RTS), Injury Severity Score (ISS), Modified Abbreviated Injury Severity Scale (MISS), Pediatric Trauma Score (PTS), and TRISS-b survival statistic. Significant correlations between scoring systems and hospital course parameters existed. TRISS-b had the strongest correlation for days in the intensive care unit and total complications (r2 = 0.59, 0.58). PTS correlated poorly with recovery variables when compared to other scoring systems. The TS correlated most strongly with ventilatory days and complications of immobilization (r2 = 0.77, 0.58). The TS should be used early in the assessment of the pediatric polytrauma patient, along with the TRISS-b statistic. If they predict prolonged intensive care unit and ventilatory days and hospital complications, operative fracture management should be strongly considered.