Pediatric Gunshot Injury Severity Scores, Shock Indexes, and Clinical Outcomes in the Greater New Orleans Area
Location
Medical Education Building, LSUHSC-NO
Presentation Date
10-10-2019 10:00 AM
End Date
10-10-2019 12:00 PM
Description
Introduction: Trauma is experienced differently amongst pediatric - adolescent patients compared to adults. In the Greater New Orleans area, trauma is one of the top reason’s children are brought to the emergency department. The current research was conducted to investigate the correlation between ethnic groups, injury severity score (ISS), shock index, and clinical outcomes of pediatric patients that presented to the emergency department from January of 2012 to March of 2019.
Methods: This is a retrospective chart review of pediatric patients who presented to the Emergency Department of UMCNO with a mechanism of injury meeting criteria for a level 1 trauma activation. Patients meeting criteria was identified through a chart review conducted by the principal investigator and co-investigators. The investigators identified patients who presented to the Emergency Department of UMCNO under a level 1 trauma activation. The investigators reviewed demographic and clinical data associated with that same file. All statistical analyses were carried out in SAS 9.4. We calculated descriptive statistics to estimate distributional properties of all variables. Fisher’s exact or Pearson chi-square tests were used to assess the associations between categorical variables.
Results: In total, 420 pediatric patients presented to UMC emergency department from January of 2012 to March of 2019 with gunshot injuries. The highest frequency of patients that presented were black patients 90.7% and of that percentage 84.0% were males. Even with the highest frequency of gunshot injuries, black patients had a lower shock index (471.7% of them being in the 0.51-0.75 shock index group) compared to the non-blacks with gunshot injuries (38.5% of them being in the 0.76-100 shock index group). There was no significant difference in ISS with respect to race (P=0.8656). There was a significant relationship between injury classification and race (P<0.0001): among the assault group, majority of the patients were black (95.32%) while only 4.68% were non-black (this is also true for accidental). Interestingly, among the self-inflicted group, majority of the patients were non-black (66.67%). There was no relationship between race and survival (P=0.8137).
Conclusion: The findings indicated that there was not a significant relationship between race and clinical outcome even though the greatest number of patients that presented to UMC’s emergency department were black patients. Non-black patients tended to present with high shock index scores, and thus are at a greater risk of mortality. This relationship may be due to that non-black patients were more likely to present to the emergency department with gunshot injuries to the head, while black patients were more likely to present with gunshot injuries to extremities or pelvic girdle. Injury severity scores were spread evenly across blacks and non-blacks, but the odds of death increased by a factor of 1.2 for each unit increase in ISS. Thus, a person with an ISS of 2 was 1.2 times more likely to die than a person with an ISS of 1.
Recommended Citation
Moreno-Walter, Lisa; Etienne, Joshua; and Rhodes, Stacey, "Pediatric Gunshot Injury Severity Scores, Shock Indexes, and Clinical Outcomes in the Greater New Orleans Area" (2019). Medical Student Research Poster Symposium. 14.
https://digitalscholar.lsuhsc.edu/sommrd/2019/posters/14
Pediatric Gunshot Injury Severity Scores, Shock Indexes, and Clinical Outcomes in the Greater New Orleans Area
Medical Education Building, LSUHSC-NO
Introduction: Trauma is experienced differently amongst pediatric - adolescent patients compared to adults. In the Greater New Orleans area, trauma is one of the top reason’s children are brought to the emergency department. The current research was conducted to investigate the correlation between ethnic groups, injury severity score (ISS), shock index, and clinical outcomes of pediatric patients that presented to the emergency department from January of 2012 to March of 2019.
Methods: This is a retrospective chart review of pediatric patients who presented to the Emergency Department of UMCNO with a mechanism of injury meeting criteria for a level 1 trauma activation. Patients meeting criteria was identified through a chart review conducted by the principal investigator and co-investigators. The investigators identified patients who presented to the Emergency Department of UMCNO under a level 1 trauma activation. The investigators reviewed demographic and clinical data associated with that same file. All statistical analyses were carried out in SAS 9.4. We calculated descriptive statistics to estimate distributional properties of all variables. Fisher’s exact or Pearson chi-square tests were used to assess the associations between categorical variables.
Results: In total, 420 pediatric patients presented to UMC emergency department from January of 2012 to March of 2019 with gunshot injuries. The highest frequency of patients that presented were black patients 90.7% and of that percentage 84.0% were males. Even with the highest frequency of gunshot injuries, black patients had a lower shock index (471.7% of them being in the 0.51-0.75 shock index group) compared to the non-blacks with gunshot injuries (38.5% of them being in the 0.76-100 shock index group). There was no significant difference in ISS with respect to race (P=0.8656). There was a significant relationship between injury classification and race (P<0.0001): among the assault group, majority of the patients were black (95.32%) while only 4.68% were non-black (this is also true for accidental). Interestingly, among the self-inflicted group, majority of the patients were non-black (66.67%). There was no relationship between race and survival (P=0.8137).
Conclusion: The findings indicated that there was not a significant relationship between race and clinical outcome even though the greatest number of patients that presented to UMC’s emergency department were black patients. Non-black patients tended to present with high shock index scores, and thus are at a greater risk of mortality. This relationship may be due to that non-black patients were more likely to present to the emergency department with gunshot injuries to the head, while black patients were more likely to present with gunshot injuries to extremities or pelvic girdle. Injury severity scores were spread evenly across blacks and non-blacks, but the odds of death increased by a factor of 1.2 for each unit increase in ISS. Thus, a person with an ISS of 2 was 1.2 times more likely to die than a person with an ISS of 1.