Paediatric trauma and hypocalcaemia: a systematic review
Bibliographic record
Abstract
BACKGROUND: Trauma is a leading cause of mortality and morbidity in children worldwide. While adult studies have demonstrated hypocalcaemia's association with adverse outcomes, its impact on paediatric trauma patients remains understudied. This systematic review aims to investigate current evidence into the prevalence, clinical implications and associations of hypocalcaemia in paediatric trauma. METHODS: A comprehensive literature search was conducted searching four databases, grey literature and additional sources for original studies looking at outcomes for paediatric trauma patients with ionised calcium measurements before blood product administration. Exclusion criteria comprised studies which included patients with blood product administration prior to calcium measurement, case reports, case series, reviews and papers not available in English. The review protocol is registered with the International Prospective Register of Systematic Reviews (PROSPERO): CRD42023432473. Data extraction was performed on included papers and quality assessment performed using Newcastle-Ottawa Scale. RESULTS: Of 779 initial studies, two studies met inclusion criteria for detailed analysis. Both retrospective cohort studies originated in Israel and collectively included 568 patients. Hypocalcaemia incidence ranged from 5.3% to 19.8%. Although trends towards increased mortality, blood transfusion requirements and prolonged hospital stays were observed in patients with hypocalcaemia, statistical significance was not consistently achieved. CONCLUSION: Hypocalcaemia in paediatric trauma appears reduced in incidence compared with adult populations. Limited available studies suggest potential associations with adverse outcomes, although most were not statistically significant. Studies had small patient numbers, necessitating further prospective research to facilitate a clearer understanding. Insights from such studies can guide patient management and improve outcomes in this vulnerable population. PROSPERO REGISTRATION NUMBER: CRD42023432473.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.005 | 0.026 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.006 | 0.005 |
| Bibliometrics | 0.009 | 0.012 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".