الفهرس 
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Abstract
T
his was a prospective RCT study conducted on 124 children with trauma; to evaluate SIPA as a quick feasible method for triaging and managing paediatric trauma, to predict ICU admission and need for CT scan as a primary outcome and also secondary outcomes like length of hospital stay, need for surgical intervention and mortality rate.
Trending SIPA was measured on admission and then 6 hourly for 24 hours if normal and for 48 hours if abnormal on admission.
Our aim was to compare group A using SIPA to group B using standard vital signs (Blood pressure, pulse and capillary refill) in terms of need for ICU admission, length of hospital stay, need for surgical intervention, need for CT and mortality.
Regarding clinical data; we found that; the mean age of all patients was (6.4 ± 3.7) years. Regarding gender of the patients, the majority (65.3%) of patients were males; while (34.7%) were females.
Regarding basic clinical data; the average GCS scale was (14 ± 2.2), with (52.4%) had abdominal pain, and (28.2%) had vomiting.
Regarding Mechanism of injury; (25%) of patients had AVP, (13.7%) had Crush injury, (50.8%) had fall, and (10.5%) had MVA.
Regarding primary outcome data; (81.5%) of patients had ICU admission, (71%) Needed CT scan, (43.5%) had positive CT findings.
Regarding Secondary outcome data; the average LOS was (12.6 ± 7.8) days, with (14.5%) needed surgical intervention, while (8.1%) had mortality.
The 124 pediatric trauma children were classified according to used vital score into 2 independent groups: group A (SIPA) (62 patients) and group B (conventional vital signs) (62 patients).
Comparative study between the 2 groups revealed;
• Non-significant difference as regards age and sex of the patients (p > 0.05).
• Non-significant difference as regards all basic clinical data (p > 0.05).
• Significant decrease in ICU admission and need for CT scan, in group A (SIPA); compared to B group (p < 0.05).
• Non-significant difference as regards positive CT findings (p > 0.05).
• Significant decrease in LOS and mortality rate, in group A (SIPA); compared to B group (p < 0.05).
• Non-significant difference as regards Need for surgical intervention (p > 0.05).
Correlation studies between different outcomes; and its relative independent predictors (basic clinical, and vital scores variables) revealed that;
• Spearman’s correlation analysis shows that; SIPA score had a significant positive correlation with LOS (p = 0.023).
• Spearman’s correlation analysis shows that; SBP had a significant negative correlation with LOS (p < 0.01).
By using ROC-curve analysis, SIPA score at a cutoff point (>1) predicted patients with ICU admission, with good (82%) accuracy, sensitivity= 78% and specificity= 71% (p < 0.01).
By using ROC-curve analysis, SIPA score at a cutoff point (>1.3) predicted mortality, with good (82%) accuracy, sensitivity= 100% and specificity= 80% (p < 0.01).
Conclusion
To conclude, SIPA score proven to be an accurate and specific predictor of morbidity, hospital stay, ICU admission, and mortality rate in pediatric trauma patients and is superior to capillary refill time, tachycardia or hypotension alone for predicting different outcomes.
RECOMMENDATIONS
• Compared to the ability of conventional vital signs in assessing poor outcomes, SIPA score successfully predicted the need for CT, ICU admission and interventions.
• We have used age-specific pediatric cut-offs of shock index for categorizing children into “high SIPA” and “low SIPA” and it showed good sensitivity and septicity.