Risk Factor Score of Battle et al for Complications Following Blunt Chest Wall Trauma

 

NOTE: Battle previously identified risk factors for mortality following blunt chest trauma.

 

Patient selection: age >= 10 (based on wording of point assignment for age)

 

Outcomes: pulmonary complications (pneumonia, chest infection, hemothorax, pneumothorax, pleural effusion, empyema), other complications, ICU admission, prolonged length of stay (>= 7 days), mortality

 

Parameters:

(1) age of the patient in years

(2) number of rib fractures (not number of ribs with fractures)

(3) chronic lung disease prior to trauma

(4) anticoagulant use prior to trauma

(5) oxygen saturation level in percent

 

Parameter	Finding	Points
number of rib factures		3 * <fractures>
chronic lung disease	absent	0
	present	5
anticoagulant use	no	0
	yes	4

 

Points for age is “per additional 10-year increase starting at 10 years of age.”

 

points for age =

= MAX(0,(((age) – 10) / 10)

 

Points for oxygen saturation is “per 5% decrease in oxygen saturation starting at 94%.”

 

Oxygen Saturation	Points
> 94%	0
<= 94%	2 * ((94 – (saturation in percent)) / 5)

 

For age and oxygen saturation there are 2 options for point assignment:

(1) ROUND to the nearest integer

(2) allow the raw count

 

total score =

= SUM(points for all 5 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: > 31

• The higher the score the greater the risk of complications.

 

Risk Score	Percent Complications
0 to 10	13% +/- 6
11 to 15	29% +/- 8
16 to 20	52% +/- 8
21 to 25	70% +/- 6
26 to 30	80% +/- 6
>=31	88% +/- 7