Publication: Risk prediction score for death of traumatised and injured children
Issued Date
2014-02-28
Resource Type
ISSN
14712431
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2-s2.0-84896710443
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Mahidol University
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SCOPUS
Bibliographic Citation
BMC Pediatrics. Vol.14, No.1 (2014)
Suggested Citation
Sakda Arj ong Vallipakorn, Adisak Plitapolkarnpim, Paibul Suriyawongpaisal, Pimpa Techakamolsuk, Gary A. Smith, Ammarin Thakkinstian Risk prediction score for death of traumatised and injured children. BMC Pediatrics. Vol.14, No.1 (2014). doi:10.1186/1471-2431-14-60 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/34288
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Thesis
Title
Risk prediction score for death of traumatised and injured children
Abstract
Background: Injury prediction scores facilitate the development of clinical management protocols to decrease mortality. However, most of the previously developed scores are limited in scope and are non-specific for use in children. We aimed to develop and validate a risk prediction model of death for injured and Traumatised Thai children.Methods: Our cross-sectional study included 43,516 injured children from 34 emergency services. A risk prediction model was derived using a logistic regression analysis that included 15 predictors. Model performance was assessed using the concordance statistic (C-statistic) and the observed per expected (O/E) ratio. Internal validation of the model was performed using a 200-repetition bootstrap analysis.Results: Death occurred in 1.7% of the injured children (95% confidence interval [95% CI]: 1.57-1.82). Ten predictors (i.e., age, airway intervention, physical injury mechanism, three injured body regions, the Glasgow Coma Scale, and three vital signs) were significantly associated with death. The C-statistic and the O/E ratio were 0.938 (95% CI: 0.929-0.947) and 0.86 (95% CI: 0.70-1.02), respectively. The scoring scheme classified three risk stratifications with respective likelihood ratios of 1.26 (95% CI: 1.25-1.27), 2.45 (95% CI: 2.42-2.52), and 4.72 (95% CI: 4.57-4.88) for low, intermediate, and high risks of death. Internal validation showed good model performance (C-statistic = 0.938, 95% CI: 0.926-0.952) and a small calibration bias of 0.002 (95% CI: 0.0005-0.003).Conclusions: We developed a simplified Thai pediatric injury death prediction score with satisfactory calibrated and discriminative performance in emergency room settings. © 2014 Vallipakorn et al.; licensee BioMed Central Ltd.