Navarrete-Navarro et al developed a model for predicting acute respiratory distress syndrome (ARDS) in patients with severe trauma. These can help to identify a patient who may benefit from more aggressive management. The authors are from multiple hospitals in Spain.
Patient selection: age > 14 years with severe trauma (ISS >=16 and/or RTS <= 11)
Parameters from multivariate analysis within 24-hours of admission:
(1) APACHE II score
(2) number of red blood cell units transfused
(3) chest trauma (rib and/or sternal fractures, ICD-9 807)
(4) femoral fracture (ICD-9 820-821)
X =
= (0.05 * (APACHE II)) + (0.28 * (red blood cell units)) + (1.35 if chest trauma present, else 0) + (1.15 if femoral fracture, else 0) - 4.03
probability of ARDS =
= 1 / (1 + EXP((-1) * X))
Additional risk factors on univariate analysis:
(1) fractures of femur, tibia, humerus, and pelvis
(2) >= 2 long bone fractures
(3) chest trauma
(4) hemo/pneumothorax
