Brian F Flaherty1, Margaret L Jackson2, Charles S Cox3, Amy Clark4, Linda Ewing-Cobbs5, Richard Holubkov4, Kevin R Moore6, Rajan P Patel7, Heather T Keenan4. 1. Division of Critical Care, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT. Electronic address: Brian.flaherty@hsc.utah.edu. 2. Department of Surgery, University of Texas McGovern Medical School, Houston, TX. 3. Department of Pediatric Surgery, University of Texas McGovern Medical School, Houston, TX. 4. Division of Critical Care, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT. 5. Department of Pediatrics and Children's Learning Institute, University of Texas McGovern Medical School, Houston, TX. 6. Department of Medical Imaging, Primary Children's Hospital, Salt Lake City, UT. 7. Division of Neuroradiology, Department of Diagnostic and Interventional Radiology, University of Texas McGovern Medical School, Houston, TX.
Abstract
PURPOSE: To assess the Pediatric Intensity Level of Therapy (PILOT) score alone and in combination with Emergency Department (ED) GCS and Rotterdam score of initial head CT to predict functional outcomes in children with traumatic brain injury (TBI). METHODS: Children (n=108) aged 31months-15years with moderate to severe TBI were prospectively enrolled at two sites. The ability of PILOT, ED GCS, and Rotterdam scores to predict the 6-month Pediatric Injury Functional Outcome Scale (PIFOS) was evaluated using multivariable regression models with enrollment site, age, and sex as covariates. RESULTS: PILOT total (sum) score was more predictive of PIFOS (R2=0.23) compared to mean (R2 = 0.20) or peak daily PILOT scores (R2=0.11). PILOT total score predicted PIFOS better than ED GCS (R2=0.01) or Rotterdam score (R2=0.06) and was similar to PILOT, ED GCS, and Rotterdam score combined. PILOT total score performed better in patients with intracranial pressure monitors (n=30, R2=0.28, slope=0.30) than without (n=78, R2=0.09, slope=0.36). CONCLUSIONS: The PILOT score correlated moderately with functional outcome following TBI and outperformed other common predictors. PILOT may be a useful predictor or moderator of functional outcomes. LEVEL OF EVIDENCE: Prognosis study, Level II.
PURPOSE: To assess the Pediatric Intensity Level of Therapy (PILOT) score alone and in combination with Emergency Department (ED) GCS and Rotterdam score of initial head CT to predict functional outcomes in children with traumatic brain injury (TBI). METHODS:Children (n=108) aged 31months-15years with moderate to severe TBI were prospectively enrolled at two sites. The ability of PILOT, ED GCS, and Rotterdam scores to predict the 6-month Pediatric Injury Functional Outcome Scale (PIFOS) was evaluated using multivariable regression models with enrollment site, age, and sex as covariates. RESULTS: PILOT total (sum) score was more predictive of PIFOS (R2=0.23) compared to mean (R2 = 0.20) or peak daily PILOT scores (R2=0.11). PILOT total score predicted PIFOS better than ED GCS (R2=0.01) or Rotterdam score (R2=0.06) and was similar to PILOT, ED GCS, and Rotterdam score combined. PILOT total score performed better in patients with intracranial pressure monitors (n=30, R2=0.28, slope=0.30) than without (n=78, R2=0.09, slope=0.36). CONCLUSIONS: The PILOT score correlated moderately with functional outcome following TBI and outperformed other common predictors. PILOT may be a useful predictor or moderator of functional outcomes. LEVEL OF EVIDENCE: Prognosis study, Level II.
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