Validation of a relative head injury severity scale for pediatric trauma.

Background: Brain injury is the most important independent predictor of mortality and morbidity in pediatric trauma. The Glasgow Coma Score (GCS) is the commonly used clinical instrument to assess brain injury. However, the GCS or one of its components is often not applicable in children under a certain age or cannot be computed reliably because of the patient's condition or the circumstances surrounding resuscitation efforts.

The safety of central line placement prior to treatment of pediatric acute lymphoblastic leukemia.

Background: Central venous lines are placed in children with acute lymphoblastic leukemia at diagnosis, despite significant cytopenias, to facilitate the administration of chemotherapy and blood sampling. The present study aimed to determine the safety of central line placement in these patients.

Methods: We reviewed the charts of 115 consecutive patients treated during a 10-year period.

Intubation of pediatric trauma patients in the field: predictor of negative outcome despite risk stratification.

Background: Recently, evidence has shown that intubation in the field may not improve or may even adversely affect outcomes. Our objective was to analyze outcomes in pediatric intubated trauma patients using a large national pediatric trauma registry.

Methods: The patient population was derived from the last phase of the National Pediatric Trauma Registry, comprising admissions from 1994 through 2002.

Determination of national pediatric injury prevention priorities using the Injury Prevention Priority Score.

Purpose: Previous studies have found that the Injury Prevention Priority Score (IPPS) provides a reliable and valid method to gauge the relative importance of different injury causal mechanisms at individual trauma centers. This study examines its applicability to prioritizing injury mechanisms on a national level and within defined pediatric age groups.

Methods: A total of 47,158 patients (age <17) in the National Pediatric Trauma Registry were grouped into common injury mechanisms based on ICD-9 E-Codes.

Knife wound to the posterior fossa in a child.

Background: Knife wounds to the posterior fossa are a rare occurrence, especially in children. We report an 8-year-old girl who sustained a penetrating knife injury through the occipital bone into the posterior fossa. On presentation, the large knife blade was firmly embedded in her head.

Prediction of mortality in pediatric trauma patients: new injury severity score outperforms injury severity score in the severely injured.

Background: The Injury Severity Score (ISS) is a widely accepted method of measuring severity of traumatic injury. A modification has been proposed--the New Injury Severity Score (NISS). This has been shown to predict mortality better in adult trauma patients, but it had no predictive benefit in pediatric patients.

Diagnostic imaging in the follow-up of nonoperative management of splenic trauma in children.

The spleen is the most frequently injured organ in blunt abdominal trauma (BAT). Contrast-enhanced computed tomography (CT) is approximately 95% sensitive and specific for detection of splenic injury. In children, nonoperative treatment is well-established.

Development of a model for prediction of survival in pediatric trauma patients: comparison of artificial neural networks and logistic regression.

Background/purpose: There is a paucity of outcome prediction models for injured children. Using the National Pediatric Trauma Registry (NPTR), the authors developed an artificial neural network (ANN) to predict pediatric trauma death and compared it with logistic regression (LR).

Methods: Patients in the NPTR from 1996 through 1999 were included.

Lymphocyte-predominant Hodgkin disease in children.

Purpose: To describe the clinicobiological features, treatment, treatment outcome, and sequelae of children with lymphocyte-predominant Hodgkin disease.

Patients And Methods: The authors performed a retrospective chart review of 754 patients with Hodgkin disease diagnoses at New York Medical College and St. Jude Children's Research Hospital from 1962 to 2000 to identify those with lymphocyte-predominant histology.