Pediatric Trauma Severity Assessment and Prognosis Using Automated Scoring Systems

Background: Trauma remains one of the leading causes of morbidity and mortality in the pediatric population. Early assessment of injury severity is essential for timely triage, risk stratification, and clinical decision-making. The Revised Trauma Score (RTS), Pediatric Trauma Score (PTS), and Shock Index (SI) are widely used tools for evaluating physiological status and trauma severity in injured children.

Materials and Methods: A prospective observational study was conducted between December 2025 and March 2026 and included 100 pediatric trauma patients registered in the Pediatric Trauma Support System (PTSS). Patients were stratified into four age groups: ≤2 years (n=15), 2-6 years (n=39), 6-12 years (n=34), and 12-18 years (n=12). RTS, PTS, and SI were calculated automatically within the PTSS platform. Severe trauma was defined as hemodynamic instability and/or a Pediatric Trauma Score below 8. Six patients met the criteria for severe trauma. Descriptive statistical analysis was performed.

Results: Patients with severe trauma demonstrated lower PTS values (5-6/12), RTS values ranging from 6.00 to 7.11, and a mean SI of 1.38. In children aged ≤2 years, PTS values decreased to 9/12 even in cases of minor head injury, while RTS remained 7.84 and mean SI was 1.27, reflecting age-related physiological differences. In the 2-6 and 6-12 year groups, PTS values ranged from 10-11/12, RTS remained stable at 7.84, and SI ranged from 0.80 to 1.11. Similar patterns were observed among adolescents aged 12-18 years. The combined assessment of RTS, PTS, and SI provided complementary information regarding injury severity across age groups.

Conclusions:RTS, PTS, and SI remain useful tools for the early assessment of pediatric trauma patients. Their integration within the PTSS clinical decision-support platform enables standardized calculation and facilitates rapid evaluation in emergency settings. Age-related physiological variations should be considered when interpreting trauma scores in children.