Validity of Triage Early Warning Score (TEWS) and Pediatric Trauma Score (PTS) in Predicting Mortality in Pediatric Patients with Severe Trauma at Prof. Dr. I.G.N.G. Ngoerah Central General Hospital

Francis Noor Yanong Celeste^1*, Kadek Deddy Ariyanta², and I Ketut Sudartana²

Abstract

Introduction: Trauma remains a leading cause of morbidity and mortality in children, highlighting the importance of accurate triage tools for early identification of high-risk patients. The Pediatric Trauma Score (PTS) has long been utilized, and the Triage Early Warning Score (TEWS) has demonstrated good predictive value for mortality in emergency settings; however, its validity in severe pediatric trauma, particularly in Indonesia, remains insufficiently explored. Objective: This study aimed to compare the validity of TEWS and PTS in predicting mortality among pediatric patients with severe trauma in the Emergency Department (ED) of Prof. Dr. I.G.N.G. Ngoerah Central General Hospital. Methods: A retrospective observational analytic cohort study was conducted using medical record data from July to December 2023. The sample included 39 pediatric patients (<18 years) with severe trauma (Injury Severity Score >15). Statistical analyses included sensitivity, specificity, positive and negative predictive values, accuracy, Receiver Operating Characteristic (ROC) analysis with area under the curve (AUC), optimal cut-off determination, and correlation testing. Results: Both TEWS and PTS demonstrated 100% sensitivity for mortality prediction. TEWS showed higher specificity (76% vs 50%), positive likelihood ratio (4.16 vs 2), and overall accuracy (79% vs 56%) compared to PTS. ROC analysis revealed high predictive performance for both scores (AUC TEWS 0.965; PTS 0.982), with no significant difference (p=0.654). Optimal cut-offs were TEWS ≥7 and PTS ≤5.5. TEWS was significantly associated with intensive care requirements (p<0.001), unlike PTS. Conclusion: TEWS demonstrates superior validity compared to PTS in predicting mortality in pediatric patients with severe trauma.

Keywords

triage early warning score; pediatric trauma score; pediatric trauma; mortality; validity.

Cite This Article

Celeste, F. N. Y., Ariyanta, K. D., Sudartana, I. K. (2026). Validity of Triage Early Warning Score (TEWS) and Pediatric Trauma Score (PTS) in Predicting Mortality in Pediatric Patients with Severe Trauma at Prof. Dr. I.G.N.G. Ngoerah Central General Hospital. International Journal of Scientific Advances (IJSCIA), Volume 7| Issue 1: Jan – Feb 2026, Pages 195-204 URL: https://www.ijscia.com/wp-content/uploads/2026/02/Volume7-Issue1-Jan-Feb-No.1033-195-204.pdf

Volume 7 | Issue 1: Jan – Feb 2026