Etienne St. Louis
- Residency Program: McGill University
- Supervisors: Dr. Dan Poenaru, Dr. Tarek Razek, Dr. Edmond Ntaganda,
Etienne St-Louis is a third year General Surgery resident who completed three years of dedicated research time during residency. While enrolled in the Clinician Investigator Program, he completed a MSc in Clinical Epidemiology at McGill University, and has gone on to a PhD in Experimental Surgery, which is ongoing.
Etienne completed medical school at McGill University in 2013. His research has focused on pediatric trauma in low-income settings. Etienne has pursued the development of a user-friendly patient-level risk stratification model for pediatric trauma outcomes benchmarking in low- and middle-income countries.
Ninety-five percent of all childhood injury deaths occur in Low- and Middle-Income Countries (LMICs). It is estimated that approximately one million children die each year as a result of injury and violence.. The burden of childhood injury represents a significant public health problem and weighs heaviest on the world’s lowest-income populations.
The proliferation of trauma registries in LMICs is well documented. Trauma performance benchmarking and quality improvement require standardised metrics for risk-adjustment according to severity of patient injury as well as availability of human and material resources. As trauma registries develop in LMICs, the models used to estimate and compare patient injury severity must be adapted to the current resource limitations of these settings. Furthermore, pediatric trauma patients have distinct physiology compared with their adult counterparts and therefore require appropriately adapted severity indicators.
During his MSc of Epidemiology, Etienne used his newly acquired skills of predictive model development to create the Pediatric Resuscitation and Trauma Outcomes (PRESTO) model using the ACS National Trauma Data Bank, which uses 6 low-tech variables available at point of care in virtually all environments to predict in-hospital mortality of injured children.
In order to use PRESTO in the LMIC setting, however, the model coefficients needed to be calibrated to reflect trauma mortality rates in this environment. The next phase of his research therefore required him to partner up with one or more hospitals in LMICs to develop new trauma registries to validate his model. He used this knowledge in his experiences travelling to Rwanda, where he helped revive the Rwanda Injury Registry, in partnership with the University of Rwanda and University Teaching Hospital in Kigali. This partnership allowed him to calibrate and validate the model, demonstrating its superior discrimination compared with other well validated models such as the Kampala Trauma Score and the Revised Trauma Score.
St-Louis E, Seguin J, Deckelbaum DL, Baird R, Razek T. Pediatric trauma scores – Systematic review and needs assessment in low-resource settings. Pediatr Surg Int. 2016; 33(3):299-309.
St-Louis E, Deckelbaum DL, Baird R, Razek T. Optimizing the assessment of pediatric injury severity in low-resource settings: Consensus generation through a modified Delphi analysis. Injury. 2017;48(6):1115-9.
St-Louis E, Roizblatt D, Deckelbaum DL, Baird R, Valenzuela CM, Ebensperger A, Razek T. Identifying pediatric trauma data gaps at a large urban trauma referral center in Santiago, Chile. Panam J Trauma Crit Care Emerg Surg. 2017;6(3):169-176
St-Louis E, Razek T, Hanley JA, Baird R. Development and validation of a new Pediatric Resuscitation and Trauma Outcome (PRESTO) score using the U.S. National Trauma Data Bank. J Pediatr Surg.2018; 53:136-140.
Goodman L, St-Louis E, Yousef Y, Cheung M, Ure B, Ozgediz D, Ameh E, Bickler S, Oldham K, Farmer D, Lakhoo K. The Global Initiative for Children’s Surgery: Optimal resources for improving care. Eur J Pediatr Surg. 2018; 28:51-59
St-Louis E, Paradis T, Landry T, Poenaru D. Strategies for Successful Trauma Registry Implementation in Low- and Middle-Income Countries: A Systematic Review. Injury. 2018; 49(12):2100-2110