MONDAY, Sept. 21, 2026 (HealthDay News) -- In injured children, mortality is associated with substantially higher systolic blood pressure (SBP) thresholds than those currently used to define hypotension, according to a study published online Sept. 9 in the Journal of the American College of Surgeons.
Chandler A. Annesi, M.D., from the University of Alabama at Birmingham, and colleagues conducted a retrospective analysis of the American College of Surgeons Trauma Quality Improvement Program (2018 to 2023), including injured children aged 1 to 15 years, to derive age-specific SBP, heart rate (HR), and shock index (SI) thresholds associated with mortality. These thresholds were compared to hypotension definitions from Pediatric Advanced Life Support (PALS), age-based tachycardia thresholds, and the Pediatric Age-adjusted Shock Index (SIPA).
The researchers found that mortality-associated SBP thresholds were consistently 15 to 30 mm Hg higher than PALS hypotension definitions among 233,490 pediatric trauma patients, while a difference of 0 to 30 beats/minute was seen for HR thresholds versus traditional age-based values. There was a close approximation between derived SI thresholds and established SIPA values, supporting their validity. Among children aged 1 to 2 years, the greatest divergence occurred between data-derived and conventional thresholds.
"Injured children are treated in emergency departments across the country, not only at pediatric trauma centers," Annesi said in a statement. "Providing clinicians with more accurate thresholds for recognizing instability could help them identify children at risk earlier and monitor them more closely."
One author disclosed ties to the biopharmaceutical and medical device industries.
