Killien et al identified risk factors for acute respiratory distress (ARDS) in a pediatric trauma patient. These can help to identify a patient who may benefit from more aggressive management. The authors are from the University of Washington and Seattle Children's Research Institute.

Patient selection: pediatric trauma, on admission


Risk factors for ARDS by multivariable logistic regression adjusted for age and transfer status:

(1) African-American (odds ratio 1.4)

(2) mechanism of injury

(2a) firearm (odds ratio 1.9)

(2b) motor vehicle (odds ratio 1.9)

(2c) pedestrian or cyclist (odds ratio 1.4)

(2d) struck by/against (odds ratio 1.2)

(2e) other (odds ratio 1.9)

(3) site of injury

(3a) spine (odds ratio 1.4)

(3b) lower extremities (odds ratio 1.3)

(3c) chest injury (odds ratio 1.4)

(4) amputations (odds ratio 2.1)

(5) high Injury Severity Score

(5a) ISS 9-15 (odds ratio 1.6)

(5b) ISS 16-24 (odds ratio 2.2)

(5c) ISS 25-39 (odds ratio 3.4)

(5d) ISS 40-75 (odds ratio 3.7)

(6) Glasgow coma scale

(6a) 13 or 14 (odds ratio 1.8)

(6b) 9 to 12 (odds ratio 3.4)

(6c) 6 to 8 (odds ratio 5.4)

(6d) 4 or 5 (odds ratio 6.8)

(6e) 3 (odds ratio 5.6)

(7) intubated (odds ratio 1.7)

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