Physiologic Trauma Scores of Kuhls et al for Predicting Mortality in Adult Trauma Patients

 

Parameters:

(1) systemic inflammatory response score (SIRS), see table below

(2) Glasgow Coma Score (GCS), with scores ranging from 3 to 15

(3) age in years

 

Parameters for the SIRS:

(1) temperature

(2) heart rate

(3) respiratory rate

(4) neutrophil count (white blood cell count times percent neutrophilic series)

 

SIRS Parameter	Finding	Points
temperature	< 36°C	1
	36 – 38°C	0
	> 38°C	1
heart rate	> 90 beats per minute	1
	<= 90 beats per minute	0
respiratory rate	> 20 breaths per minute	1
	<= 20 breaths per minute	0
neutrophil count	< 4,000 per µL	1
	4,000 – 12,000 per µL	0
	> 12,000 per µL	1
	> 10% band forms	1

 

SIRS =

= SUM(points for all 4 parameters)

 

score 1 =

= (0.045 * (SIRS) * (GCS)) + (0.055 * (age in years)) – (0.506 * (GCS)) – 0.942

 

score 2 =

= (0.595 * (SIRS)) + (0.056 * (age in years)) – (0.421 * (GCS)) – 1.922

 

probability of death =

= 1 / (1 + EXP((-1)*(score)))

 

where:

• On page 701, the risk of death is given as LN(score). However, if the score results are placed in the equation, an error value is returned.

 

Performance:

• Hosmer-Lemeshow chi-square 2.84 for score 1 and 3.58 for score 2.

• The authors found the scores comparable to TRISS and superior to ISS for predicting mortality.