TY - JOUR
T1 - Use of the BIG score to predict mortality in pediatric trauma
AU - Bolstridge, Jeff
AU - O'Neil, Erika R.
AU - Aden, James K.
AU - Muisyo, Teddy
AU - Spinella, Philip C.
AU - Borgman, Matthew A.
N1 - Funding Information:
None.
Publisher Copyright:
© 2020
PY - 2021/7
Y1 - 2021/7
N2 - Objective: 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). Methods: 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). Results: 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. Conclusions: 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.
AB - Objective: 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). Methods: 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). Results: 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. Conclusions: 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.
KW - BIG score
KW - Mortality
KW - Pediatric trauma
KW - Severity of illness
UR - http://www.scopus.com/inward/record.url?scp=85092779450&partnerID=8YFLogxK
U2 - 10.1016/j.ajem.2020.09.060
DO - 10.1016/j.ajem.2020.09.060
M3 - Article
C2 - 33077313
AN - SCOPUS:85092779450
SN - 0735-6757
VL - 45
SP - 472
EP - 475
JO - American Journal of Emergency Medicine
JF - American Journal of Emergency Medicine
ER -