Evidence map›Paper›PMID 32314007›Full record

ArticleWorld journal of surgery2020

Comparison of the Pediatric Resuscitation and Trauma Outcome (PRESTO) Model and Pediatric Trauma Scoring Systems in a Middle-Income Country.

Michael D Traynor, Etienne St Louis, Matthew C Hernandez, Ahmed S Alsayed, Denise B Klinkner, Robert Baird, Dan Poenaru, Victor Y Kong, Christopher R Moir, Martin D Zielinski and 3 more

Registry-linked trialAbstract readComparative Study
PubMed Publisher
In one paragraph

Article in World journal of surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06075108 (P-KIDs CARE), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06075108 narecruitingnot on this mapstarted 2024, after this paper: background citation

P-KIDs CARE: An Intervention to Address Health Systems Delays to Care for Injured Children in Tanzania

TypeinterventionalSponsorUniversity of UtahRan2024 to 2028Enrolled284ConditionsAccidental Injuries, Global Child Health, Pediatric Emergency Medicine, Public Health System ResearchArmsP-KIDs CARE
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. A cohort of pediatric injury patients from a hospital-based trauma registry in Northern Tanzania.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2022
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Michael D TraynorDepartment of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55902, USA. traynor.michael@mayo.edu.
Etienne St LouisCenter for Global Survery, McGill University Health Centre, Montreal, Canada.
Matthew C HernandezDepartment of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55902, USA.
Ahmed S AlsayedDepartment of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55902, USA.
Denise B KlinknerDepartment of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55902, USA.
Robert BairdDivision of Pediatric General Surgery, British Columbia Children's Hospital, Vancouver, Canada.
Dan PoenaruCenter for Global Survery, McGill University Health Centre, Montreal, Canada.
Victor Y KongUniversity of KwaZulu-Natal, Pietermaritzburg, South Africa.
Christopher R MoirDepartment of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55902, USA.
Martin D ZielinskiDepartment of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN, 55902, USA.
Grant L LaingUniversity of KwaZulu-Natal, Pietermaritzburg, South Africa.
John L BruceUniversity of KwaZulu-Natal, Pietermaritzburg, South Africa.
Damian L ClarkeUniversity of KwaZulu-Natal, Pietermaritzburg, South Africa.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe pediatric resuscitation and trauma outcome (PRESTO) model was developed to aid comparisons of risk-adjusted mortality after injury in low- and middle-income countries (LMICs). We sought to validate PRESTO using data from a middle-income country (MIC) trauma registry and compare its performance to the Pediatric Trauma Score (PTS), Revised Trauma Score, and pediatric age-adjusted shock index (SIPA).

methodsWe included children (age < 15 years) admitted to a single trauma center in South Africa from December 2012 to January 2019. We excluded patients missing variables necessary for the PRESTO model-age, systolic blood pressure, pulse, oxygen saturation, neurologic status, and airway support. Trauma scores were assigned retrospectively. PRESTO's previously high-income country (HIC)-validated optimal threshold was compared to MIC-validated threshold using area under the receiver operating characteristic curves (AUROC). Prediction of in-hospital death using trauma scoring systems was compared using ROC analysis.

resultsOf 1160 injured children, 988 (85%) had complete data for calculation of PRESTO. Median age was 7 (IQR: 4, 11), and 67% were male. Mortality was 2% (n = 23). Mean predicted mortality was 0.5% (range 0-25.7%, AUROC 0.93). Using the HIC-validated threshold, PRESTO had a sensitivity of 26.1% and a specificity of 99.7%. The MIC threshold showed a sensitivity of 82.6% and specificity of 89.4%. The MIC threshold yielded superior discrimination (AUROC 0.86 [CI 0.78, 0.94]) compared to the previously established HIC threshold (0.63 [CI 0.54, 0.72], p < 0.0001). PRESTO showed superior prediction of in-hospital death compared to PTS and SIPA (all p < 0.01).

conclusionPRESTO can be applied in MIC settings and discriminates between children at risk for in-hospital death following trauma. Further research should clarify optimal decision thresholds for quality improvement and benchmarking in LMIC settings.

Indexed as

AdolescentAlgorithmsArea Under CurveBlood PressureChildChild, PreschoolEmergency MedicineFemaleHeart RateHospitalizationHospital MortalityHumansIncomeInfantInfant, NewbornMale

Identifiers

PMID32314007

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.