Reverse shock index multiplied by Glasgow Coma Scale as a predictor of emergency intervention in pediatric isolated blunt abdominal trauma

In pediatric blunt abdominal trauma, early identification of patients requiring emergency interventions is crucial. The Revised Shock Index multiplied by the Glasgow Coma Scale (rSIG) is a useful prognostic tool. However, its utility in pediatric abdominal trauma remains unclear. This study aimed to evaluate its usefulness in predicting the need for emergency intervention in pediatric isolated blunt abdominal trauma. We conducted a retrospective cohort study using data from the Japan Trauma Data Bank between January 1, 2010 and December 31, 2022. Pediatric patients aged ≤15 years with isolated blunt abdominal trauma were included. rSIG was calculated using vital signs and GCS scores at presentation. In the derivation cohort, the optimal cutoff value for predicting the need for emergency intervention was determined using the Youden index; in the validation cohort, patients were stratified into abnormal (rSIG < cutoff) and normal (rSIG ≥ cutoff) groups. The association between rSIG and emergency interventions was analyzed. Diagnostic performance was assessed using receiver operating characteristic curve analysis. Overall, 869 patients were included. The optimal rSIG cutoff value for all age groups was 12.7. In the validation cohort, the abnormal group had significantly higher rates of emergency intervention, surgery, transfusion, and intubation. Although the area under the receiver operating characteristic curve for rSIG was 0.657, indicating moderate diagnostic performance, its high negative predictive value suggests potential utility in eliminating the need for emergency intervention. This study validates rSIG as a simple screening tool for emergency interventions in pediatric blunt isolated abdominal trauma.