J Korean Soc Emerg Med.  2017 Dec;28(6):579-586. 10.0000/jksem.2017.28.6.579.

The Usefulness of the mPTS (modified pediatric trauma score) and Newly Developed Extended mPTS as a High Risk Pediatric Trauma Patients Screening Tool: Support of Two Tiered Trauma Team Activation System

Affiliations
  • 1Department of Emergency Medicine, Pusan National University Hospital, Busan, Korea. jrmr9933@gmail.com
  • 2Department of Emergency Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.
  • 3Department of Trauma and Surgical Critical Care, Pusan National University Hospital, Busan, Korea.

Abstract

PURPOSE
A secondary triage tool for pediatric trauma patients, "modified pediatric trauma score (mPTS)" was introduced to predict high risk trauma.
METHODS
Pediatric trauma patients (≤15 years) presenting to the Pusan National University Hospital trauma center emergency department were analyzed retrospectively. The patients were classified into high risk and low risk groups. The high risk group was assigned an Injury Severity Score ≥12, death, intensive care unit admission, or urgent intervention (intubation, closed thoracostomy, emergency angiography and embolization, emergency surgery). The airway, blood pressure, fractures, level of consciousness, and external wounds were evaluated and the mPTS was calculated.
RESULTS
One hundred seventy-seven patients were enrolled in this study. The mPTS had a sensitivity, specificity, positive predictive value, and negative predictive value of 88%, 54%, 60%, and 85%, respectively. Overtriage and undertriage was 39% and 14%, respectively. The mPTS missed 6 high risk patients and all 6 patients were abdominal injury patients. The mPTS was modified to include an abdominal physical examination and/or focused assessment with sonography for trauma. The newly developed scoring system was called the extended mPTS (E-mPTS). The E-mPTS had a sensitivity of 98% and negative predictive value of 98%. The safe level of overtriage (38%) was maintained.
CONCLUSION
mPTS was applied to the patients and the undertriage rate was too high. The extended mPTS improved undertriage to 2% while maintaining the overtriage rate at a safe level. The E-mPTS is expected to have a resource saving effect when used as a pediatric trauma team activation standard.

Keyword

Wounds and injuries; Triage; Pediatrics; Emergency medicine

MeSH Terms

Abdominal Injuries
Angiography
Blood Pressure
Busan
Consciousness
Emergencies
Emergency Medicine
Emergency Service, Hospital
Humans
Injury Severity Score
Intensive Care Units
Mass Screening*
Pediatrics
Physical Examination
Retrospective Studies
Sensitivity and Specificity
Thoracostomy
Trauma Centers
Triage
Wounds and Injuries
Full Text Links
  • JKSEM
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2022 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr