Introduction: Emergency department trauma triage can be challenging for injured pediatric patients. For verbal children (and adults), the Glasgow Coma Scale (GCS) is commonly used to assess disability, and a modified GCS assessment tool is used for the pre-verbal age group. A common disability assessment for both verbal and pre-verbal pediatric patients to risk-stratify the need for higher acuity trauma care or mortality would be useful. The primary aim was to investigate whether using only the motor component of GCS (mGCS) compared to total GCS (tGCS) was associated with intensive care management or mortality in the pediatric population. The strength of association for the composite outcome for verbal (≥ 2 years old) and pre-verbal children (15) traumatic injuries from January 2012 to December 2021. The data were prospectively collected from the hospital’s trauma registry. Results: Among 582 included for analysis, the median age was seven years old (interquartile range 2-12), who were predominantly male (63.4%). 22.4% of patients died or required ICU care. Overall, adjusted relative risks (aRR) for tGCS and mGCS to predict ICU/mortality were 0.86(95%CI: 0.84 to 0.89) and 0.76(95%CI: 0.70 to 0.81), respectively. The aRR to predict for ICU/mortality in children <2-years-old for tGCS was 0.83(95%CI: 0.78 to 0.88), and mGCS was 0.76(95%CI: 0.70 to 0.81). The aRR to predict for ICU/mortality in children ≥ 2 years old for tGCS was 0.88(95%CI: 0.84 to 0.91), and mGCS was 0.76(95%CI: 0.70 to 0.83). Conclusion: mGCS may be a viable alternative to tGCS for disability assessment to predict the need for ICU care or mortality in moderately to severely injured verbal and pre-verbal children.
Ong et al. (Sun,) studied this question.