Background: Two years after the first cases, critical gaps remain in identifying prognostic factors in multisystem inflammatory syndrome in children (MIS-C). Methods: This retrospective study included 99 patients with MIS-C hospitalized between August 2020 and March 2022 in a pediatric tertiary center. The patients were divided into two groups according to clinical severity (low- and high-risk). Prognostic values of baseline clinical and laboratory characteristics were evaluated with advanced statistical analysis, including machine learning. Results: Sixty-three patients were male, and the median age was 83 (3–205) months. Fifty-nine patients (59.6%) were low-risk cases. Patients aged six years and over tended to be at higher risk. Involvement of aortic or tricuspid valve or >1 valve was more frequent in the high-risk group. Mortality in previously healthy children was 3.2%. Intensive care unit admission and mortality rate in the high-risk group were 37.5% and 7.5%, respectively. At admission, high-risk patients were more likely to have reduced lymphocyte count and total protein level and increased brain natriuretic peptide (BNP), ferritin, D-dimer, and troponin concentrations. The multiple logistic regression model showed that BNP, total protein, and troponin were associated with higher risk. When the laboratory parameters were used together, BNP, total protein, ferritin, and D-dimer provided the highest contribution to the discrimination of the risk groups (100%, 89.6%, 85.6%, and 55.8%, respectively). Conclusions: Our study widely evaluates and points to some clinical and laboratory parameters that, at admission, may indicate a more severe course. Modeling studies with larger sample groups are strongly needed.

Objective: This study aimed to evaluate the effectiveness of various trauma scoring systems in predicting mortality in pediatric patients with multiple trauma and to determine their cut-off values. Materials and Methods: A methodological study was conducted on pediatric patients under 18 years of age admitted to the pediatric intensive care unit for multiple trauma. Demographic data, clinical parameters, and trauma scores, including the Revised Trauma Score (RTS), Pediatric Trauma Score (PTS), Glasgow Coma Scale (GCS), Abbreviated Injury Scale (AIS), Injury Severity Score (ISS), Pediatric Risk of Mortality Score III (PRISM-3), and Pediatric Logistic Organ Dysfunction (PELOD-2), were collected and analyzed. Results: Among the 107 patients, there were 15 deaths (14%). Significant differences were observed between survivors and non-survivors in all trauma scores. Non-survivors had higher AIS, ISS, PRISM-3, and PELOD-2 scores, while survivors had higher PTS, RTS, and GCS scores (P < .001). In the multivariate binary logistic regression analysis, both ISS (odds ratio [OR] 1.060 [95% CI: 1.029-1.092], P < .001) and RTS (OR 0.059 [95% CI: 0.007-0.517], P =.011) were independently associated with mortality. Injury Severity Score demonstrated the highest area under the curve (AUC) value of 0.98 in the receiver operating characteristic (ROC) analysis. Conclusion: Both ISS and RTS were identified as independent predictors of mortality in pediatric trauma patients. Injury Severity Score was the strongest predictor, while RTS also provided significant prognostic value. Integration of these scores into early assessment may enhance risk stratification and support clinical decision-making in pediatric trauma care. Cite this article as: Dündar MA, Can ST, Akyıldız BN. Evaluating trauma scores for mortality prediction in pediatric patients. Turk Arch Pediatr. 2025;60(4):391-397.

Çocuklarda uyku dinamik bir süreçtir. Çocuklarda uyku bozuklukları nispeten yaygındır, ancak klinik pratikte fark edilmesi zordur. Uyku bozuklukları büyüyen çocuğun tıbbi, psikolojik ve gelişimsel yönlerini etkileyebileceği için doğru tanı ve etkin tedavisi, gündüz uyku hali, sinirlilik, davranış sorunları, öğrenme güçlükleri, gençlerde motorlu araç kazaları ve düşük akademik performans gibi olumsuz sonuçların önlenmesi için büyük bir önem arz etmektedir. Bu kitapta, bebeklikten ergenliğe kadar çocuklarda uykunun temel yönleri ve pediatri pratiğinde karşılaşılması muhtemel en yaygın uyku bozuklukları alanında uzman bilim insanları ve araştırmacılar tarafından ele alınmıştır. Bu kitabın Çocuk Nörolojisi Bilim Dalı araştırma görevlilerinin ve Çocuk Nörolojisi uzmanlarının hem eğitim süreçlerine katkı sağlayacağını hem de günlük hasta pratiğinde bir başucu kitabı olacağını umut ediyoruz.

Background: Two years after the first cases, critical gaps remain in identifying prognostic factors in multisystem inflammatory syndrome in children (MIS-C). Methods: This retrospective study included 99 patients with MIS-C hospitalized between August 2020 and March 2022 in a pediatric tertiary center. The patients were divided into two groups according to clinical severity (low and high-risk). Prognostic values of baseline clinical and laboratory characteristics were evaluated with advanced statistical analysis, including machine learning. Results: Sixty-three patients were male, and the median age was 83 (3–205) months. Fifty-nine patients (%59.6) were low-risk cases. Patients aged six years and over tended to be at higher risk. Involvement of aortic or tricuspid valve or >1 valve was more frequent in the high-risk group. Mortality in previously healthy children was 3.2%. Intensive care unit admission and mortality rate in the high-risk group were 37.5% and 7.5%, respectively. At admission, high-risk patients were more likely to have reduced lymphocyte count and total protein level and increased brain natriuretic peptide (BNP), ferritin, D-dimer, and troponin concentrations. The multiple logistic regression model showed that BNP, total protein, and troponin were associated with higher risk. When the laboratory parameters were used together, BNP, total protein, ferritin, and D-dimer provided the highest contribution to the discrimination of the risk groups (100%, 89.6%, 85.6%, and 55.8%, respectively). Conclusions: Our study widely evaluates and points to some clinical and laboratory parameters that, at admission, may indicate a more severe course. Modeling studies with larger sample groups are strongly needed.