Asensio et al developed models for predicting mortality and postoperative complications in patients with major trauma involving femoral blood vessels. The authors are from Los Angeles County and the University of Southern California Medical Center.
Parameters used in stepwise logistic regression:
(1) Injury Severity Score (ISS)
(2) Glasgow Coma Score (GCS)
(3) age of the patient in years
(4) coagulopathy noted in the operating room (OR)
(5) number of hard vascular signs
(6) intimal disruption in a femoral artery
(7) thoracic injury
(8) hypotension in the operating room
(9) bony fracture
Hard signs of vascular injury:
(1) signs of distal ischemia
(2) absent or diminished pulses
(3) expanding hematoma
(4) palpable thrill
(5) pulsatile bleeding
(6) presence of a bruit
Parameter |
Finding |
Points |
---|---|---|
Injury Severity Score |
<= 25 |
0 |
|
> 25 |
1 |
Glasgow Coma Score |
>=8 |
0 |
|
< 8 |
1 |
age of the patient in years |
<= 45 years |
0 |
|
> 45 years |
1 |
coagulopathy noted in OR |
absent |
0 |
|
present |
1 |
number of hard vascular signs |
0 or 1 |
0 |
|
>= 2 |
1 |
intimal disruption in artery |
absent |
0 |
|
present |
1 |
thoracic injury |
absent |
0 |
|
present |
1 |
hypotension in the OR |
absent |
0 |
|
present |
1 |
bony fracture |
absent |
0 |
|
present |
1 |
X =
= (3.1088 * (points for ISS)) + (2.5670 * (points for GCS)) + (2.1933 * (points for age)) + (2.1170 * (points for coagulopathy)) + (2.0876 * (points for hard vascular signs)) - 6.3057
probability of mortality =
= 1 / (1 + EXP((-1) * X))
Y =
= (2.5247 * (points for intimal disruption)) + (1.7701 * (points for thoracic injury)) + (1.6218 * (points for hypotension)) + (0.8590 * (points for bony fracture)) - 1.2110
probability of postoperative complications =
= 1 / (1 + EXP((-1) * Y))
Purpose: To estimate the risk of mortality and complications in a patient with major trauma involving femoral blood vessels as reported by Asensio et al.
Specialty: Surgery, orthopedic, Emergency Medicine, Critical Care, Surgery, general, Cardiology
Objective: risk factors, criteria for diagnosis, severity, prognosis, stage, complications, options
ICD-10: S75,