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<p>This study aimed to evaluate the effectiveness of combining initial hemoglobin levels with the shock index for predicting the need for life-saving interventions (LSI) in pediatric patients with blunt liver and spleen injuries (BLSI), specifically tailored to different age groups. This was a multicenter retrospective cohort study of pediatric patients with BLSI in Japan. The area under the receiver operating characteristic curve (AUROC) were used to assess predictive accuracy. The study included 1,370 patients. LSI was required in 59 of 247 (23.9%) aged 1 to 6&#xa0;years, 100 of 402 (24.9%) aged 7 to 12&#xa0;years, and 125 of 297 (42.1%) patients aged 13 to 16&#xa0;years. Within each specific age group, the predictability was categorized as fair and appeared higher than that of the entire cohort or when using either parameter alone. Notably, in the 1 to 6-year age group, the combined values showed the highest predictability, which was statistically superior to the shock index alone (AUROC of 0.770 vs. 0.671, P = 0.025). Tailoring initial hemoglobin levels and shock index to specific age groups enhances predictability of LSI in pediatric BLSI, showing a fair level of predictive accuracy.</p>

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Age-specific assessment of initial hemoglobin levels and shock index for predicting life-saving interventions in pediatric blunt liver and spleen injuries

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年3月12日

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  • Tetsuya Yumoto,
  • Takafumi Obara,
  • Takashi Hongo,
  • Atsuyoshi Iida,
  • Kohei Tsukahara,
  • Morihiro Katsura,
  • Yutaka Kondo,
  • Hideto Yasuda,
  • Shigeki Kushimoto,
  • Takashi Yorifuji,
  • Hiromichi Naito,
  • Atsunori Nakao,
  • Tetsuya Yumoto,
  • Atsuyoshi Iida,
  • Morihiro Katsura,
  • Yutaka Kondo,
  • Hideto Yasuda,
  • Shigeki Kushimoto,
  • Hiromichi Naito,
  • Tomoya Ito,
  • Motoyoshi Yamamoto,
  • Yoshihiro Yamamoto,
  • Hiroto Manase,
  • Nozomi Takahashi,
  • Akinori Osuka,
  • Suguru Annen,
  • Nobuki Ishikawa,
  • Kazushi Takayama,
  • Keita Minowa,
  • Kenichi Hakamada,
  • Akari Kusaka,
  • Mineji Hayakawa,
  • Shota Kawahara,
  • Satoshi Hirano,
  • Marika Matsumoto,
  • Kohei Kusumoto,
  • Hiroshi Kodaira,
  • Chika Kunishige,
  • Keiichiro Toma,
  • Yusuke Seino,
  • Michio Kobayashi,
  • Masaaki Sakuraya,
  • Takafumi Shinjo,
  • Shigeru Ono,
  • Haruka Taira,
  • Kazuhiko Omori,
  • Yoshio Kamimura,
  • Atsushi Shiraishi,
  • Rei Tanaka,
  • Yukihiro Tsuzuki,
  • Yukio Sato,
  • Noriaki Kyogoku,
  • Masafumi Onishi,
  • Kaichi Kawai,
  • Kazuyuki Hayashida,
  • Keiko Terazumi,
  • Akira Kuriyama,
  • Susumu Matsushime,
  • Osamu Takasu,
  • Toshio Morita,
  • Nagato Sato,
  • Wataru Ishii,
  • Michitaro Miyaguni,
  • Shingo Fukuma,
  • Yosuke Nakabayashi,
  • Yoshimi Ohtaki,
  • Kiyoshi Murata,
  • Masayuki Yagi,
  • Tadashi Kaneko,
  • Shigeru Takamizawa,
  • Akihiro Yasui,
  • Yasuaki Mayama,
  • Masafumi Gima,
  • Ichiro Okada,
  • Asuka Tsuchiya,
  • Koji Ishigami,
  • Yukiko Masuda,
  • Yasuo Yamada,
  • Hiroshi Yasumatsu,
  • Kenta Shigeta,
  • Kohei Kato,
  • Fumihito Ito,
  • Yoshitaka Saegusa,
  • Tomohiko Azuma,
  • Shima Asano,
  • Takehiro Umemura,
  • Norihiro Goto,
  • Takao Yamamoto,
  • Junichi Ishikawa,
  • Elena Yukie Uebayashi,
  • Shunichiro Nakao,
  • Yuko Ogawa,
  • Takashi Irinoda,
  • Yuki Narumi,
  • Miho Asahi,
  • Takayuki Ogura,
  • Takashi Hazama,
  • Shokei Matsumoto,
  • Daisuke Miyamoto,
  • Keisuke Harada,
  • Narumi Kubota,
  • Yusuke Konda,
  • Takeshi Asai,
  • Tomohiro Muronoi,
  • Kazuhide Matsushima,
  • Toru Hifumi,
  • Kasumi Shirasaki,
  • Shigeyuki Furuta,
  • Atsuko Fujikawa,
  • Makoto Takaoka,
  • Kaori Ito,
  • Satoshi Nara,
  • Atsushi Tanikawa,
  • Masato Tsuchikane,
  • Naoya Miura,
  • Naoki Sakoda,
  • Tadaaki Takada,
  • Shogo Shirane,
  • Akira Endo,
  • Keita Nakatsutsumi,
  • Kenta Sugiura,
  • Yusuke Hagiwara,
  • Tamotsu Gotou

摘要

This study aimed to evaluate the effectiveness of combining initial hemoglobin levels with the shock index for predicting the need for life-saving interventions (LSI) in pediatric patients with blunt liver and spleen injuries (BLSI), specifically tailored to different age groups. This was a multicenter retrospective cohort study of pediatric patients with BLSI in Japan. The area under the receiver operating characteristic curve (AUROC) were used to assess predictive accuracy. The study included 1,370 patients. LSI was required in 59 of 247 (23.9%) aged 1 to 6 years, 100 of 402 (24.9%) aged 7 to 12 years, and 125 of 297 (42.1%) patients aged 13 to 16 years. Within each specific age group, the predictability was categorized as fair and appeared higher than that of the entire cohort or when using either parameter alone. Notably, in the 1 to 6-year age group, the combined values showed the highest predictability, which was statistically superior to the shock index alone (AUROC of 0.770 vs. 0.671, P = 0.025). Tailoring initial hemoglobin levels and shock index to specific age groups enhances predictability of LSI in pediatric BLSI, showing a fair level of predictive accuracy.