Titre :

Prothrombin Time ratio can predict mortality in severe pediatric trauma: Study in a French trauma center level 1.

Auteur(s) :

Hochart, Audrey [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Momal, Romain [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Huet Garrigue, Delphine [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Drumez, Elodie [Auteur]
Evaluation des technologies de santé et des pratiques médicales - ULR 2694 [METRICS]
Susen, Sophie [Auteur]
Récepteurs nucléaires, maladies cardiovasculaires et diabète - U 1011 [RNMCD]
Bijok, Benjamin [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]

Titre de la revue :

American Journal of Emergency Medicine

Pagination :

2041-2044

Éditeur :

Elsevier

Date de publication :

2020-11-11

ISSN :

0735-6757

Mot(s)-clé(s) en anglais :

Pediatric
Trauma
Prothrombin Time ratio
Mortality
Coagulopathy

Discipline(s) HAL :

Sciences du Vivant [q-bio]

Résumé en anglais : [en]

BackgroundInjury results in more deaths in children than all other causes combined, but there is little data regarding the association of early coagulopathy on outcomes in pediatric patients with traumatic injuries. The ...
Lire la suite >BackgroundInjury results in more deaths in children than all other causes combined, but there is little data regarding the association of early coagulopathy on outcomes in pediatric patients with traumatic injuries. The aim of this study was to determine the optimal cut-off value for the Prothrombin Time ratio (PTr) and to show the diagnostic characteristics of the PTr to predict mortality.MethodsWe retrospectively included during 4 years all patients less than 16 years old referred to our trauma center for traumatic injury with ISS ≥9.ResultsA total of 272 children were included. Mean age was 9.4 ± 4.8 years and median ISS was 17 [interquartile range, 12 to 26]. Day 28 mortality was 6.7%. The optimal cut-off value in our population for predicting day 28 mortality was 1.24. Using this value, the sensitivity of PTr was 84%, specificity was 82%, positive likelihood ratio was 4.7, and negative likelihood ratio was 0.19. Early mortality (i.e., mortality at 24 h) was also well-predicted (1.0% versus 16.4%, p < .0001), as the need for massive transfuion. Similarly, patients with PTr ≥1.24 at admission presented with a higher rate of severe thoracic and abdominal trauma, higher ISS, higher likelihood of admission to an intensive care unit, longer hospitalization, and higher rate of significant procedure (e.g., surgery or embolization).ConclusionsTrauma-induced coagulopathy defined only by a PTr ≥1.24 could be used as a severity predictive marker and as a sensitive, specific, quick, and easy to use tool for admission triage of pediatric patients.Lire moins >

Langue :

Anglais

Comité de lecture :

Oui

Audience :

Internationale

Vulgarisation :

Non

Collections :

• Récepteurs nucléaires, Maladies Cardiovasculaires et Diabète (RNMCD) - U1011

Source :

Harvested from HAL