BIG Score for Pediatric Trauma

The previously validated BIG score to predict mortality for pediatric trauma is calculated as follows: (Base deficit) + 2.5 (International normalized ratio) + (15 − Glasgow Coma Scale score). These authors evaluated its performance in a retrospective cohort of 336 children (age <19 years) who presented to a single emergency department in Canada for blunt trauma and were subsequently admitted to the pediatric intensive care unit or died.

Median age was 9 years, and overall mortality was 8% (28 patients). The most common causes of death were motor vehicle and bicycle crashes, hanging, and abuse. At a cutoff of 16, the BIG score identified all but two fatalities (sensitivity, 93%) with good specificity (83%). The area under the receiver operati…