The Cardiovascular
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Pediatric Trauma BIG Score

Base deficit, INR and GCS mortality prediction after paediatric trauma.

Pediatric Trauma BIG Score
Base deficit
Enter the base deficit as a positive number (e.g. a base excess of -8 = base deficit 8).
mmol/L
INR
Glasgow Coma Scale
points
Complete the fields above to see the result.

When to use

  • Rapid mortality risk stratification at admission after paediatric blunt or penetrating trauma.

Formula

BIG = base deficit + (2.5 x INR) + (15 - GCS). Predicted mortality = 1 / (1 + e^-(0.2 x BIG - 5.208)).

Pearls and pitfalls

  • A score <12 corresponds to roughly <5% mortality; >26 to >50%.
  • Requires an admission base deficit and INR, so it is not a purely bedside tool.

References

  1. Borgman MA, et al. Pediatric trauma BIG score: predicting mortality in children after military and civilian trauma. Pediatrics. 2011;127(4):e892-7.