Description

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))


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