Abstract text (incl. references and figure legends)
Background
There were no reports of sex-specific, pediatric age-adjusted shock index (PASI) for pediatric trauma patients in previous studies. We aimed to determined the association of PASI and in-hospital mortality of pediatric trauma patients and whether this association is differ depending on sex.
Methods
This is a prospective multi-national and multi-center cohort study using Pan-Asian Trauma Outcome Study (PATOS) registry in Asian-Pacific, conducted on pediatric patients who visited participating hospitals. The main exposure of our study was abnormal (elevated) PASI meausured at emergency department (ED). The main outcomes were in-hospital mortality. We performed multivariable logistic regression analysis to estimated the association abnormal PASI and study outcomes after adjusting potential confounders. Interaction analysis between PASI and sex were also conducted.
Results
A total 6,280 pediatric trauma patients, 10.9% (686/6,280) patients had abnormal PASI. In multivariable logistic regression analysis, abnormal PASI significantly associated with increasing in-hospital mortality (aORs (95% CI): 1.71 (1.16—2.53)). The abnormal PASI had interaction effects with sex for in-hospital mortality (1.86 (1.18—2.92) for male and 1.38 (0.64—2.95) for female (p for interaction<0.01)).
Conclusions
Abnormal PASI is associated with increase in-hospital mortality in pediatric trauma patients. The prediction power of PASI on in-hospital mortality was maintained only in the male patients. Further studies on sex-specific shock index, as well as age-specific, are needed.
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