Watkins et al developed a model for predicting acute respiratory distress syndrome (ARDS) in a patient with severe trauma. This can help to identify a patient who may benefit from more aggressive management. The authors are from Puget Sound Blood Center, University of Washington, University of Toronto, and University of Michigan.
Patient selection: adult with severe trauma
Outcome: ARDS
Parameter:
(1) APACHE II score
(2) Injury Severity Score (ISS)
(3) blunt injury
(4) pulmonary contusion
(5) massive transfusion (>= 10 RBC units in 24 hours)
(6) flail chest
(7) age in years
Parameter
Finding
Points
APACHE II
0.067 * (APACHE II)
Injury Severity Score
0.028 * (ISS)
blunt trauma
no
0
yes
1.3
pulmonary contusion
no
0
yes
0.599
massive transfusion
no
0
yes
0.847
flail chest
no
0
yes
1.877
age in years
0.022 * (age)
X =
= SUM(points for all 7 items) - 5.087
probability of ARDS =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve was 0.71.
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