@article{ref1,
title="The International Classification of Disease Critical Care Severity Score demonstrates that pediatric burden of injury is similar to that of adults: validation using the National Trauma Databank",
journal="Journal of pediatric surgery",
year="2021",
author="Snyder, Christopher W. and Barry, Tara M. and Ciesla, David J. and Thatch, Keith and Poulos, Nicholas and Danielson, Paul D. and Chandler, Nicole M. and Pracht, Etienne E.",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="BACKGROUND/PURPOSE: Resource-based severity of injury (SOI) measures, such as the International Classification of Disease (ICD) Critical Care Severity Score (ICASS), may characterize traumatic burden better than standard mortality-based measures. The purpose of this study was to validate the ICASS in a representative national-level trauma cohort and compare SOI measures between children and adults. <br><br>METHODS: The National Trauma Databank was used to derive (2008-12) and validate (2013-15) ICASS and ICD Injury Severity Scores (ICISS, standard mortality-based SOI measure). SOI metrics and outcomes were compared between pediatric, adult, and elderly age groups. Logistic regression modeling evaluated predictors of critical care resource utilization. <br><br>RESULTS: Derivation and validation cohorts consisted of 3.90 and 1.97 million patients, respectively. ICASS strongly predicted actual critical care utilization (OR 1.04, 95% CI 1.04-1.04, p<0.0001). Mean ICASS was 24.4 for children and 33.0 for adults (ratio 0.74), indicating predicted critical care utilization in children was three-quarters that of adults. In contrast, predicted pediatric mortality was less than half that of adults. <br><br>CONCLUSIONS: Mortality-based SOI measures underestimate pediatric burden of injury. This study validates ICASS and demonstrates that pediatric resource-based SOI is more similar to that of adults. ICASS is easily calculated without a trauma registry and complements mortality-based measures. Level of evidence III, retrospective comparative study.<p /> <p>Language: en</p>",
language="en",
issn="0022-3468",
doi="10.1016/j.jpedsurg.2021.05.013",
url="http://dx.doi.org/10.1016/j.jpedsurg.2021.05.013"
}