Traumatic brain injury (TBI) is an important cause of mortality and morbidity in pediatric patients. We investigated the prognostic value of systemic inflammatory indices and pediatric trauma scoring systems in predicting adverse outcomes in pediatric patients with TBI. This retrospective cross-sectional study assessed 98 children diagnosed with TBI who were admitted to our pediatric intensive care unit between January 2020 and June 2024. Patients were classified into survivor and non-survivor groups, and their clinical and laboratory parameters were compared. The median age was 54.5 months (range: 1–215 months), and 69.4% of the patients were male. The overall mortality rate was 9.2% (of 9/98 patients). Non-survivors showed a significant increase in pediatric risk of mortality (PRISM) III scores ( P < .001), pediatric trauma scores ( P = .013), and pediatric Glasgow Coma Scale scores ( P < .001) were significantly lower in non-survivors. Serum lactate ( P = .004) and procalcitonin ( P = .023) levels were significantly elevated in the non-survivor group. Among the predictive indices, the systemic immune-inflammation index ( P = .043), pan-immune-inflammation value ( P = .024), neutrophil-to-lymphocyte ratio ( P = .012), systemic inflammation response index ( P = .006), and lactate-to-albumin ratio (LAR; P < .001) were notably higher in non-survivors. According to receiver operating characteristic curve analysis, pediatric Glasgow Coma Scale scores (area under the curve = 0.881) and LAR (area under the curve = 0.854) strongly predicted mortality among the scoring systems and inflammatory indices, respectively. In pediatric patients with TBI, both pGCS scores and admission LAR values demonstrated a strong prognostic value in predicting mortality. Additionally, systemic inflammation response index, neutrophil-to-lymphocyte ratio, procalcitonin, pan-immune-inflammation value, and systemic immune-inflammation index may serve as useful markers for assessing the risk of death in children with TBI.
Gayret et al. (Fri,) studied this question.