Predictors of polytrauma outcome in children on the first day of treatment in ICU
| Title: | Predictors of polytrauma outcome in children on the first day of treatment in ICU |
|---|---|
| Authors: | K. V. Pshenisnov, Yu. S. Aleksandrovich, A. S. Lipin, G. P. Tihova, P. I. Mironov, S. A. Blinov, V. A. Evgrafov, V. E. Ironosov, V. A. Kaziakhmedov, A. N. Kondin, O. V. Kuzmin, I. N. Popova, Yu. V. Suchanov, I. V. Aleksandrovich, V. S. Potapov |
| Source: | Вестник анестезиологии и реаниматологии, Vol 21, Iss 5, Pp 66-76 (2024) |
| Publisher Information: | New Terra Publishing House, 2024. |
| Publication Year: | 2024 |
| Collection: | LCC:Medical emergencies. Critical care. Intensive care. First aid |
| Subject Terms: | polytrauma, children, outcome, unfavorable outcome, prognosis, intensive care unit, Medical emergencies. Critical care. Intensive care. First aid, RC86-88.9 |
| More Details: | The objective was to identify predictors of polytrauma outcome in children on the first day of treatment in ICU.Materials and methods. Design – multicenter, cohort, retrospective, observational study. 225 children with polytrauma were examined. The average age of children was 10 (4–14) years. There were 148 (65.8%) boys. In 65.2% of cases, the injury was received as a result of a traffic accident, catatrauma occurred in 32.6% of polytrauma. The AIS score was 34 (25–48) and the PTS score was 5 (2.0–8.0). The duration of artificial lung ventilation was 12 (0–97) hours, and treatment in ICU – 5 (2–8) days. Death was in 14.2% of cases. Results. An increase in Glasgow Coma Scale (GCS) and SpO2 by one unit (1 point, 1%) was found to reduce the risk of adverse outcome by 44% and 9%, respectively, and an increase in creatinine concentration and international normalized ratio by one unit increased the probability of patient death by 4.3 and 15.8 times, respectively. A mathematical formula was developed to assess the risk of an unfavorable outcome of polytrauma in children at the time of admission to the ICU: OR = exp (3.74–0.58 · [GCS score] – 0.09 · [SpO2] + 0.06 · [Creatinine] + 2.62 · [INR]. Its accuracy is 96.4%; sensitivity 83.4%; specificity 98.7%.Conclusion. Predictors of unfavorable outcome of polytrauma in children at admission to ICU are low scores on the Glasgow Coma Scale, severe hypoxemia, coagulopathy and kidney damage. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | Russian |
| ISSN: | 2078-5658 2541-8653 |
| Relation: | https://www.vair-journal.com/jour/article/view/1062; https://doaj.org/toc/2078-5658; https://doaj.org/toc/2541-8653 |
| DOI: | 10.24884/2078-5658-2024-21-5-66-76 |
| Access URL: | https://doaj.org/article/952f92bac6024a88b9c3ff1c95d46d94 |
| Accession Number: | edsdoj.952f92bac6024a88b9c3ff1c95d46d94 |
| Database: | Directory of Open Access Journals |
| ISSN: | 20785658 25418653 |
|---|---|
| DOI: | 10.24884/2078-5658-2024-21-5-66-76 |
| Published in: | Вестник анестезиологии и реаниматологии |
| Language: | Russian |