Can the BIG score reliably predict outcomes in pediatric traumatic brain ınjury?

IF 1.2 4区医学 Q4 CLINICAL NEUROLOGY Child's Nervous System Pub Date : 2025-04-01 DOI:10.1007/s00381-025-06809-1

Abdulrahman Özel, Servet Yüce, Esma Şengenç, Esra Nur İlbeği, İzzettin Kaya, Şevval Özyılmaz Gazneli, Meltem Erol

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Abstract

Purpose: This study aimed to evaluate the prognostic value of the BIG score in predicting mortality and functional outcomes in pediatric patients with traumatic brain injury (TBI).

Methods: A retrospective analysis was conducted on pediatric TBI patients admitted to the Pediatric Intensive Care Unit (PICU) between 2020 and 2024 at a tertiary hospital. Functional outcomes at discharge were assessed using the Functional Status Scale (FSS). Receiver operating characteristic (ROC) analysis determined the predictive accuracy of the BIG score, Pediatric Trauma Score (PTS), Pediatric Glasgow Coma Scale (pGCS), and Pediatric Risk of Mortality III (PRISM III).

Results: A total of 103 patients were included. The mortality rate was 13.6% (n = 14), and 21.4% of survivors had functional impairment at discharge. In non-survivors, the BIG score, PTS, pGCS, and PRISM III were significantly elevated (all p < 0.001). The AUC for predicting mortality was 0.966 (BIG score), 0.911 (PRISM III), 0.909 (pGCS), and 0.827 (PTS). For functional impairment, the AUC values were 0.815 (BIG score), 0.812 (pGCS), 0.715 (PRISM III), and 0.645 (PTS). Correlation analysis showed a strong association between FSS scores and mechanical ventilation duration (r = 0.786, p < 0.001) and PICU length of stay (r = 0.706, p < 0.001).

Conclusion: The BIG score is a rapid, reliable predictor of mortality and functional outcomes in pediatric TBI patients, outperforming pGCS in patients with an initial pGCS of 3. Prospective studies are needed for further validation.

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BIG评分能否可靠地预测儿童创伤性脑的预后ınjury？

目的：本研究旨在评估BIG评分在预测儿童创伤性脑损伤（TBI）患者死亡率和功能结局方面的预后价值。方法：回顾性分析某三级医院2020 - 2024年儿科重症监护病房（PICU）收治的儿童TBI患者。出院时的功能结局采用功能状态量表（FSS）进行评估。受试者工作特征（ROC）分析确定了BIG评分、儿童创伤评分（PTS）、儿童格拉斯哥昏迷量表（pGCS）和儿童死亡风险III （PRISM III）的预测准确性。结果：共纳入103例患者。死亡率为13.6% (n = 14)， 21.4%的幸存者在出院时存在功能障碍。在非幸存者中，BIG评分、PTS、pGCS和PRISM III均显著升高（均为p）。结论：BIG评分是儿童TBI患者死亡率和功能结局的快速、可靠预测指标，在初始pGCS为3的患者中优于pGCS。需要前瞻性研究来进一步验证。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Child's Nervous System 医学-临床神经学

CiteScore

3.00

自引率

7.10%

发文量

322

审稿时长

3 months

期刊介绍： The journal has been expanded to encompass all aspects of pediatric neurosciences concerning the developmental and acquired abnormalities of the nervous system and its coverings, functional disorders, epilepsy, spasticity, basic and clinical neuro-oncology, rehabilitation and trauma. Global pediatric neurosurgery is an additional field of interest that will be considered for publication in the journal.