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Is the prognosis of traumatic critically ill pediatric patients predictable?

A multicenter retrospective analysis

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A Correction to this article was published on 16 October 2023

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Summary

Background

In this retrospective study the effects of the neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), mean platelet volume to platelet count ratio (MPV/PC) values as well as C‑reactive protein (CRP) and procalcitonin (PCT) levels on the severity and mortality in critically ill child trauma cases were evaluated.

Methods

A total of 80 trauma cases aged 31 days to 16 years that were followed-up in the pediatric intensive care unit (PICU) were included in the study. The data of the patients on the first day of hospitalization (T1), the median day of intensive care admission (T2), and before discharge or exitus (T3) were analyzed. The cases were divided into three groups according to the injury severity score (ISS) as minor, moderate, and severe.

Results

Of the 80 cases 59 (73.75%) were male and 21 (26.25%) were female. The mean age of all the cases was 54.5 ± 47.8 months, and the mean PICU stay was 7.35 ± 6.64 days. Of the cases 19 (23.75%) due to motor vehicle accidents and 61 (76.25%) due to falling from heights were followed-up. The mortality rate was found to be 13.75% (11 cases). The T1, T2 and T3 NLR, MLR, MPV/PC and PCT values did not differ between the groups. The T1 and T2 CRP levels were higher in the moderate trauma group than in the severe trauma group. Also, ISS and pediatric risk of mortality 3 (PRISM-3) scores were higher while the revised injury severity classification version II (RISC II), RISC II survival and Glasgow coma scale (GCS) scores were lower in the nonsurvivors. While the T3 MLR value was lower in nonsurvival cases, the T3 MPV/PC value was found to be higher.

Conclusion

The NLR, MLR, and MPV/PC values do not predict the severity of the trauma in children. In children with severe trauma, low MLR and high MPV/PC values can be used to predict mortality.

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Authors and Affiliations

  1. Istanbul Medeniyet University, Faculty of Medicine, Goztepe Prof Dr Suleyman Yalcin City Hospital, Istanbul, Turkey

    Ulkem Kocoglu Barlas M.D.

  2. University of Health Sciences Turkey, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey

    Nihal Akcay M.D.

  3. University of Health Sciences Turkey, Prof Dr Cemil Tascioglu City Hospital, Istanbul, Turkey

    Mey Talip M.D.

  4. University of Health Sciences Turkey, Bakirkoy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey

    Mehmet Emin Menentoglu M.D. &  Esra Sevketoglu M.D.

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Correspondence to Ulkem Kocoglu Barlas M.D..

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U. Kocoglu Barlas, N. Akcay, M. Talip, M.E. Menentoglu and E. Sevketoglu declare that they have no competing interests.

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Due to an unfortunate oversight the author has been also affiliated erroneously to University of Health Sciences Turkey, Bakirkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey

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Kocoglu Barlas, U., Akcay, N., Talip, M. et al. Is the prognosis of traumatic critically ill pediatric patients predictable?. Wien Klin Wochenschr 135, 639–645 (2023). https://doi.org/10.1007/s00508-023-02269-2

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