Description

Stopenski et al reported the Prehospital Injury Mortality Score (PIMS) for evaluating trauma patients. Prehospital variables can help to identify a patient at increased risk of mortality. The authors are from the University of California Irvine and UCLA.


Patient selection: blunt trauma, primarily adults (median age 58 years)

 

Parameters:

(1) age in years

(2) sex of the patient

(3) mechanism of injury

(4) Glasgow Coma Scale (GCS)

(5) systolic blood pressure in mm Hg

(6) respiratory rate in breaths per minute

(7) skull fracture

 

High-risk blunt mechanism - one or more of the following:

(1) fall > 20 feet or > 2 stories

(2) crash intrusion > 12 inches occupant site

(3) crash intrusion > 18 inches driver

(4) crash ejection

(5) crash AND death in same compartment

(6) automobile vs pedestrian thrown, run over, or hit at over 20 mph

(7) automobile vs bicyclist thrown, run over or hit at over 20 mph

(8) burns with trauma

 

Parameter

Finding

Points

age in years

< 65 years of age

0

 

>= 65 years of age

2

sex

male

1

 

female

0

mechanism of injury

high-risk blunt

1

 

other

0

Glasgow coma scale

14 or 15

0

 

3 to 13

6

systolic blood pressure

< 90 mm Hg

3

 

>= 90 mm Hg

0

respiratory rate

< 10 breaths per minute

4

 

10 to 29 breaths per minute

0

 

> 29 breaths per minute

4

skull fracture

open

3

 

depressed

3

 

other

0

 

none

0

 

total score =

= SUM(points for all of the parameter)

 

Interpretation:

• minimum score: 0

• maximum score: 20

• The higher the score the greater the mortality.

 

Total Score

Mortality

0

0%

1 or 2

1 to 2%

3

4%

4 to 7

10 to 15%

8 or 9

20 to 25%

10 to 12

30 to 40%

13 or 14

60 to 70%

15 to 18

80%

19 or 20

100%

 

Performance:

• The area under the ROC curve is 0.79.


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