ArticleFrontiers in pediatrics2026
Development and validation of a clinical nomogram for predicting 30-day in-hospital mortality in children with moderate-to-severe traumatic brain injury.
Article in Frontiers in pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Traumatic brain injury is a major cause of death and disability in children, and early identification of high-risk cases is critical for improving clinical outcomes. Objective: This study aimed to develop and validate a clinical prediction model to estimate the 30-day in-hospital mortality in pediatric patients with moderate-to-severe traumatic brain injury (msTBI). Methods: A retrospective analysis was conducted on 289 pediatric patients admitted with msTBI. Independent risk factors were identified using the least absolute shrinkage and selection operator regression and multivariable logistic regression analysis to construct a clinical nomogram. Model performance was assessed using ROC curves, bootstrap validation, and decision curve analysis. Results: The median age of the cohort was 5.17 (IQR, 2.75-9.33) years. There were 101 females and 188 males. Four independent predictors were identified: Glasgow Coma Scale score, lactic acid, albumin, and trauma-induced coagulopathy. The model showed AUC of 0.898 (95% CI: 0.896, 0.899) and good agreement between predicted and observed outcomes. Hosmer-Lemeshow test yielded a non-significant Conclusion: This study developed a reliable clinical tool to predict 30-day in-hospital mortality in children with msTBI. It may support early risk stratification and assist clinicians in making informed treatment decisions.
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