Evidence map›Paper›PMID 37019480›Full record

ArticleBMJ open2023

Validation of the Pediatric Resuscitation and Trauma Outcome (PRESTO) model in injury patients in Tanzania.

Elizabeth M Keating, Modesta Mitao, Arthi Kozhumam, Joao Vitor Souza, Cecilia S Anthony, Dalton Breno Costa, Catherine A Staton, Blandina T Mmbaga, Joao Ricardo Nickenig Vissoci

Registry-linked trialAbstract read
In one paragraph

Article in BMJ open, 2023. 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 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Review
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

9 authors.

Elizabeth M KeatingDepartment of Pediatrics, Division of Pediatric Emergency Medicine, University of Utah, Salt Lake City, Utah, USA elizabeth.keating@hsc.utah.edu.ORCID 0000-0002-5263-6612
Modesta MitaoKilimanjaro Christian Medical Centre, Moshi, Tanzania, United Republic of.
Arthi KozhumamFeinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
Joao Vitor SouzaState University of Maringa, Maringa, Paraná, Brazil.
Cecilia S AnthonyKilimanjaro Christian Medical Centre, Moshi, Tanzania, United Republic of.
Dalton Breno CostaDepartment of Computer Science, University of North Carolina at Greensboro (UNCG), Greensboro, North Carolina, USA.
Catherine A StatonDepartment of Emergency Medicine, Duke University Medical Center, Durham, North Carolina, USA.
Blandina T MmbagaKilimanjaro Christian Medical Centre, Moshi, Tanzania, United Republic of.
Joao Ricardo Nickenig VissociDepartment of Emergency Medicine, Duke University Medical Center, Durham, North Carolina, USA.

Funding

Vanderbilt-Emory-Cornell-Duke Global Health Fellowship Consortium-Expanding Diversity for Global Equity (EDGE)D43TW009337 · FIC · VANDERBILT UNIVERSITY MEDICAL CENTER · PI ALIYU, MUKTAR HASSAN, HEIMBURGER, DOUGLAS CORBETT · 2017 to 2021
$6.3M
FIC NIH HHS D43 TW009337
6 · The paper itself

Abstract

introductionSub-Saharan Africa has the highest rate of unintentional paediatric injury deaths. The Pediatric Resuscitation and Trauma Outcome (PRESTO) model predicts mortality using patient variables available in low-resource settings: age, systolic blood pressure (SBP), heart rate (HR), oxygen saturation, need for supplemental oxygen (SO) and neurologic status (Alert Verbal Painful Unresponsive (AVPU)). We sought to validate and assess the prognostic performance of PRESTO for paediatric injury patients at a tertiary referral hospital in Northern Tanzania.

methodsThis is a cross-sectional study from a prospective trauma registry from November 2020 to April 2022. We performed exploratory analysis of sociodemographic variables and developed a logistic regression model to predict mortality using R (V.4.1). The logistic regression model was evaluated using area under the receiver operating curve (AUC).

results499 patients were enrolled with a median age of 7 years (IQR 3.41-11.18). 65% were boys, and in-hospital mortality was 7.1%. Most were classified as alert on AVPU Scale (n=326, 86%) and had normal SBP (n=351, 98%). Median HR was 107 (IQR 88.5-124). The logistic regression model based on the original PRESTO model revealed that AVPU, HR and SO were statistically significant to predict in-hospital mortality. The model fit to our population revealed AUC=0.81, sensitivity=0.71 and specificity=0.79.

conclusionThis is the first validation of a model to predict mortality for paediatric injury patients in Tanzania. Despite the low number of participants, our results show good predictive potential. Further research with a larger injury population should be done to improve the model for our population, such as through calibration.

Indexed as

Accidental InjuriesWounds and InjuriesChildChild, PreschoolCross-Sectional StudiesFemaleHumansLogistic ModelsMalePrognosisRegistriesTanzaniaACCIDENT & EMERGENCY MEDICINEPaediatric A&E and ambulatory carePaediatric intensive & critical carePAEDIATRIC SURGERYTRAUMA MANAGEMENT

Identifiers

PMID37019480
PMCPMC10083748

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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.