Risk Factors of de Moya et al for Mechanical Ventilation in a Patient with Blunt Pulmonary Contusion

 

Patient selection: blunt pulmonary contusion

 

Parameters:

(1) Glasgow Coma Score (GCS)

(2) number of fractured ribs

(3) number of lung fields (out of 6) showing any evidence of opacification on the admission chest X-ray (using the BPC6, see below)

Parameter	Finding	Points
Glasgow Coma Score	14 or 15	0
	3 to 13	1
number of fractured ribs	0 to 4	0
	>= 5	1
contusion on chest X-ray	0, 1 or 2 (out of 6)	0
	>= 3 (out of 6)	1

 

where:

• The odds ratio for mechanical ventilation was 118 for GCS, 9 for fractured ribs and 13 for contusion on chest X-ray (Table 4, page 1545). Therefore, GCS needs to be weighted more if 1 or 2 factors are present.

 

total score =

= SUM(points for all 3 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 3

• The higher the score the more likely that mechanical ventilation will be needed.

• Patients with all 3 factors usually required mechanical ventilation.

• Patients with none of the risk factors did not require mechanical ventilation 100% of the time.