BIG Score and Its Comparison with Different Scoring Systems for Mortality Prediction in Children with Severe Traumatic Brain Injury Admitted in Pediatric Intensive Care Unit

Objective: We aimed to determine the association of BIG score with mortality in pediatric traumatic brain injury (TBI) and its comparison with other trauma scores. Materials and Methods: A retrospective review of medical records of all children, aged 1–18 years, who were admitted in our pediatric intensive care unit within 24 h of trauma (from January 2015 to December 2018), was carried out. Data were collected on a structured case report form (CRF). They were analyzed using STATA version 15. Results: Ninety-four patients were identified. Data were collected on a structured CRF. Median BIG, Injury Severity Scoring (ISS), Pediatric Trauma Score (PTS), and New Injury Severity Score (NISS) were 15 (9.3–18), 13 (9–19), 4 (2–6), and 13 (9–22), respectively. Cutoffs for all scores were calculated using the Youden index, which was 19 for BIG score, 13.5 for ISS, 13.5 for NISS, and 3.5 for PTS. On the univariate analysis, younger age, tachycardia in the first 24 h, hypotension on arrival, base deficit, deranged international normalization ratio, low Glasgow Coma Scale and higher BIG score, higher ISS, and higher NISS scores were associated with mortality. Using the multivariate regression analysis, BIG score was associated with mortality. The BIG score had an area under the curve (AUC) of 0.802 (0.650–0.956) with the highest specificity of 90.5% (82.1–95.8%) and ISS had an AUC of 0.756 (0.702–0.810) with the highest sensitivity of 100% (69.2–100%). Conclusion: BIG and ISS are specific and sensitive scores, respectively, to predict mortality in pediatric TBI.