Ability of the PILOT score to predict 6-month functional outcome in pediatric patients with moderate–severe traumatic brain injury
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In brief
In brief
Prospective study of 108 children with moderate-severe TBI demonstrating that the PILOT score (Pediatric Intensity Level of Therapy) better predicts 6-month functional outcomes than traditional measures like ED Glasgow Coma Scale or Rotterdam CT scoring. PILOT total score showed moderate correlation with outcomes and performed particularly well in patients requiring intracranial pressure monitoring.
Written by the GCMD Library team from the article.
Purpose
To assess the Pediatric Intensity Level of Therapy (PILOT) score alone and in combination with Emergency Department (ED) GCS and Rotterdam score of initial head CT to predict functional outcomes in children with traumatic brain injury (TBI).
Methods
Children (n=108) aged 31months–15years with moderate to severe TBI were prospectively enrolled at two sites. The ability of PILOT, ED GCS, and Rotterdam scores to predict the 6-month Pediatric Injury Functional Outcome Scale (PIFOS) was evaluated using multivariable regression models with enrollment site, age, and sex as covariates.
Results
PILOT total (sum) score was more predictive of PIFOS (R2=0.23) compared to mean (R2 = 0.20) or peak daily PILOT scores (R2=0.11). PILOT total score predicted PIFOS better than ED GCS (R2=0.01) or Rotterdam score (R2=0.06) and was similar to PILOT, ED GCS, and Rotterdam score combined. PILOT total score performed better in patients with intracranial pressure monitors (n=30, R2=0.28, slope=0.30) than without (n=78, R2=0.09, slope=0.36).
Conclusions
The PILOT score correlated moderately with functional outcome following TBI and outperformed other common predictors. PILOT may be a useful predictor or moderator of functional outcomes.
Level of evidence
Prognosis study, Level II.