{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T02:56:25Z","timestamp":1783392985235,"version":"3.54.6"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T00:00:00Z","timestamp":1665619200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,28]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To explore the optimal set of trauma activation criteria predicting paediatric patients\u2019 need for acute care following multi-trauma, with particular attention to Glasgow Coma Scale (GCS) cut-off value.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective cohort study of paediatric multi-trauma patients aged 0 to 16 years, performed at a Level 1 paediatric trauma centre. Trauma activation criteria and GCS levels were examined with respect to patients\u2019 need for acute care, defined as: direct to operating room disposition, intensive care unit admission, need for acute interventions in the trauma room, or in-hospital death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We enrolled 436 patients (median age 8.0 years). The following predicted need for acute care: GCS &amp;lt;14 (adjusted odds ratio [aOR] 23.0, 95% confidence interval [CI]: 11.5 to 45.9, P &amp;lt; 0.001), hemodynamic instability: (aOR 3.7, 95% CI: 1.2-8.1, P = 0.01), open pneumothorax\/flail chest (aOR: 20.0, 95% CI: 4.0 to 98.7, P &amp;lt; 0.001), spinal cord injury (aOR 15.4, 95% CI; 2.4 to 97.1, P = 0.003), blood transfusion at the referring hospital (aOR: 7.7, 95% CI: 1.3 to 44.2, P = 0.02) and GSW to the chest, abdomen, neck, or proximal extremities (aOR 11.0, 95% CI; 1.7 to 70.8, P = 0.01). Using these activation criteria would have decreased over- triage by 10.7%, from 49.1% to 37.2% and under-triage by 1.3%, from 4.7% to 3.5%, in our cohort of patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Using GCS&amp;lt;14, hemodynamic instability, open pneumothorax\/flail chest, spinal cord injury, blood transfusion at the referring hospital, and GSW to the chest, abdomen, neck of proximal extremities, as T1 activation criteria could decrease over- and under-triage rates. Prospective studies are needed to validate the optimal set of activation criteria in paediatric patients.<\/jats:p><\/jats:sec>","DOI":"10.1093\/pch\/pxac085","type":"journal-article","created":{"date-parts":[[2022,10,13]],"date-time":"2022-10-13T10:56:45Z","timestamp":1665658605000},"page":"17-23","source":"Crossref","is-referenced-by-count":5,"title":["Evaluation of activation criteria in paediatric multi-trauma"],"prefix":"10.1093","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7694-6407","authenticated-orcid":false,"given":"Neta","family":"Cohen","sequence":"first","affiliation":[{"name":"Division of Paediatric Emergency Medicine, Department of Paediatrics, SickKids, University of Toronto , Toronto, Ontario , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrienne L","family":"Davis","sequence":"additional","affiliation":[{"name":"Division of Paediatric Emergency Medicine, Department of Paediatrics, SickKids, University of Toronto , Toronto, Ontario , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gidon","family":"Test","sequence":"additional","affiliation":[{"name":"Division of Paediatric Emergency Medicine, Department of Paediatrics, SickKids, University of Toronto , Toronto, Ontario , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana","family":"Singer\u2013Harel","sequence":"additional","affiliation":[{"name":"Division of Paediatric Emergency Medicine, Department of Paediatrics, SickKids, University of Toronto , Toronto, Ontario , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yehonatan","family":"Pasternak","sequence":"additional","affiliation":[{"name":"Division of Clinical Immunology and Allergy, Department of Paediatrics, SickKids, University of Toronto , Toronto, Ontario , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne","family":"Beno","sequence":"additional","affiliation":[{"name":"Division of Paediatric Emergency Medicine, Department of Paediatrics, SickKids, University of Toronto , Toronto, Ontario , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dennis","family":"Scolnik","sequence":"additional","affiliation":[{"name":"Division of Paediatric Emergency Medicine, Department of Paediatrics, SickKids, University of Toronto , Toronto, Ontario , Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2022,10,13]]},"reference":[{"key":"2023022805301452900_","volume-title":"Health, United States, 2015: With Special Feature on Racial and Ethnic Health Disparities","author":"National Center for Health Statistics.","year":"2016"},{"key":"2023022805301452900_","volume-title":"World report on child injury prevention","author":"Peden","year":"2009"},{"key":"2023022805301452900_","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1542\/peds.2009-2416","article-title":"Annual summary of vital statistics: 2007","volume":"125","author":"Heron","year":"2010","journal-title":"Pediatrics"},{"key":"2023022805301452900_","doi-asserted-by":"crossref","first-page":"1985","DOI":"10.1016\/j.jpedsurg.2011.06.001","article-title":"Trauma activation: Are we making the right call? 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