• Eujene Jung, Young Sun Ro, Hyun Ho Ryu, Kentaro Kajino, and Sang Do Shin.
• Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Korea.
• Yonsei Med. J. 2023 Apr 1; 64 (4): 278283278-283.

PurposeThere has been no report of sex-specific, pediatric age-adjusted shock index (PASI) for pediatric trauma patients in previous studies. We aimed to determine the association between the PASI and in-hospital mortality of pediatric trauma patients and whether this association differs depending on sex.Materials And MethodsThis is a prospective, multinational, and multicenter cohort study using the Pan-Asian Trauma Outcome Study (PATOS) registry in the Asia-Pacific region, conducted in pediatric patients who visited the participating hospitals. The main exposure of our study was abnormal (elevated) PASI measured in an emergency department. The main outcome was in-hospital mortality. We performed a multivariable logistic regression analysis to estimate the association between abnormal PASI and study outcomes after adjusting for potential confounders. An interaction analysis between PASI and sex was also conducted.ResultsOf 6280 pediatric trauma patients, 10.9% (686) of the patients had abnormal PASI. In multivariable logistic regression analysis, abnormal PASI was significantly associated with increased in-hospital mortality [adjusted odds ratios (aOR), 1.74; 95% confidence interval (CI), 1.13-2.47]. Abnormal PASI had interaction effects with sex for in-hospital mortality (aOR, 1.86; 95% CI, 1.19-2.91 and aOR, 1.38; 95% CI, 0.58-2.99 for male and female, respectively) (p<0.01).ConclusionAbnormal PASI is associated with increased in-hospital mortality in pediatric trauma patients. The prediction power of PASI for in-hospital mortality was maintained only in male patients.© Copyright: Yonsei University College of Medicine 2023.

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