Vogel et al reported the Denver Emergency Department Trauma Organ Failure Score for identifying a trauma patient at risk for multi-organ failure. This can help to identify a patient who may benefit from more aggressive management. The authors are from the Denver Health Medical Center and University of Colorado.
Patient selection: trauma patient in the Emergency Department (ED)
Outcome: multiple organ failure (MOF), defined as >= 2 organ systems scored >= 3 in the SOFA score
Parameters:
(1) age in years
(2) intubation
(3) hematocrit in percent
(4) systolic blood pressure in the ED in mm Hg
(5) BUN in mg/dL
(6) white blood cell count per microliter
Parameter
Finding
Beta-Coefficient
Points
age
< 65 years
0
0
>= 65 years
1.25
1
intubation
none
0
0
non-emergent
0
0
emergent
3.11
3
hematocrit
>= 35%
0
0
20 to 34.9%
1.29
1
< 20%
2.26
2
systolic blood pressure
>= 90 mm Hg
0
0
< 90 mm Hg
0.5
2
BUN
< 30 mg/dL
0
0
>= 30 mg/dL
1.19
1
WBC count
< 20,000 per µL
0
0
>= 20,000 per µL
0.74
1
value of X =
= SUM(points for all of the beta-coefficients) - 5.06
probability of MOF =
= 1 / (1 + EXP((-1) * X))
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 9
Performance:
• The area under the ROC curve is 0.92.
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