Research Mentor Name

Elika Ridelman

Research Mentor Email Address

eridelma@dmc.org

Institution / Department

Children's Hospital of Michigan / Pediatric Surgery

Document Type

Research Abstract

Research Type

clinicalresearch

Graduate Level Research

no

Abstract

Background:
Pediatric trauma patients exhibit outcomes not fully captured by adult-derived prediction models. This study examined clinical measures associated with predicted survival in this population.

Methods:
A retrospective review was conducted at a level one pediatric trauma center for patients ≤12 years old admitted between July 2015 and October 2024 with major trauma (Injury Severity Score (ISS) >15). A total of 406 eligible cases were categorized by Trauma and Injury Severity Score (TRISS) survival probability as preventable (>0.50), possibly preventable (0.25–0.50), or non-preventable (< 0.25). Demographic, physiologic, and management variables were compared using Kruskal–Wallis and chi-square tests with Bonferroni correction.

Results:
Most patients were classified as preventable (83%), followed by possibly preventable (9.8%) and non-preventable (6.9%). Younger age correlated with lower TRISS (p = .002): median age in the preventable category was 5 years, versus 3 years in the other groups. Children in the non-preventable category, compared to the preventable group, had markedly lower GCS (median 9 vs. 15) and RTS scores (median 3.22 vs. 7.55), as well as significantly lower blood pressure and temperature values (all p < .05).

Conclusions:
Younger patients were disproportionately classified into lower TRISS categories, likely due to age-dependent physiologic norms - such as lower blood pressure, lower temperature, and immature neurologic responsiveness - that reduce GCS, RTS, and other TRISS inputs despite age-appropriate physiology. These findings suggest TRISS may underestimate survival probability in younger children and highlight the need for pediatric-specific trauma prediction tools.

Disciplines

Medicine and Health Sciences

Comments

This project was conducted as part of the Medical Student Research Fellowship. We'd also like to acknowledge the Department of Pediatric Surgery at Children’s Hospital of Michigan for supporting data access and research coordination.

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