Model of Davis et al for Predicting Probability of Multi-Organ Failure Following Trauma Based on Admission Base Deficit and Injury Severity Score (ISS)

Description

Davis et al used the admission base deficit and Injury Severity Score (ISS) to predict the probability of developing multi-organ failure for a trauma patient. This can help identify a patient who may require more aggressive management and monitoring. The authors are from the Fresno Campus of the University of California San Francisco.

If base excess is reported, then a base deficit is a negative number.

If base deficit is reported, then a base deficit is a positive number.

Base Excess	Interpretation
>= 3 mmol/L	base excess
-2 to 2	normal
-3 to -5	mild base deficit
-6 to -9	moderate base deficit
<= -10	severe base deficit

The curves in Figure 4 (page 772) plotting base status vs ISS showed the following values:

ISS	Base Excess	Normal	Mild Base Deficit	Moderate Base Deficit	Severe Base Deficit
0	0.06	0.09	0.14	0.21	0.3
5	0.08	0.12	0.19	0.27	0.38
10	0.10	0.16	0.24	0.34	0.45
15	0.14	0.21	0.30	0.41	0.53
20	0.19	0.27	0.38	0.49	0.61
25	0.24	0.34	0.45	0.58	0.69
30	0.30	0.41	0.53	0.65	0.75
35	0.38	0.49	0.61	0.72	0.81
40	0.46	0.58	0.69	0.78	0.85
45	0.53	0.65	0.76	0.83	0.89
50	0.62	0.72	0.81	0.87	0.91
55	0.69	0.79	0.85	0.9	0.94
60	0.76	0.83	0.89	0.93	0.96
65	0.81	0.87	0.92	0.95	0.97
70	0.86	0.91	0.94	0.96	0.975
75	0.89	0.93	0.96	0.97	0.982

When this data is analyzed in JMP the following equations can be used to match the curves:

Curve	ISS 0 to 35	ISS 35 to 75
Excess	(0.0001881 * ((ISS)^2)) + (0.0024881 * (ISS)) + 0.0604167	(-0.000138 * ((ISS)^2)) + (0.0282762 * (ISS)) - 0.449152
Normal	(0.0001643 * ((ISS)^2)) + (0.0057976 * (ISS)) + 0.0879167	(-0.000178 * ((ISS)^2)) + (0.030619 * (ISS)) - 0.362576
Mild Deficit	(0.0001119 * ((ISS)^2)) + (0.0094048 * (ISS)) + 0.138333	(-0.000172 * ((ISS)^2)) + (0.0274048 * (ISS)) - 0.133182
Moderate Deficit	(0.0000405 * ((ISS)^2)) + (0.0135119 * (ISS)) + 0.2045833	(-0.000145 * ((ISS)^2)) + (0.0220381 * (ISS)) + 0.1282727
Severe deficit	(-0.000052 * ((ISS)^2)) + (0.0166429 * (ISS)) + 0.296667	(-0.0001309 * ((ISS)^2)) + (0.0162386 * (ISS)) + 0.3757

Performance:

• The model had an accuracy of 76.7%.

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Description

Specialty

ICD-10