The Annals of thoracic surgery · 2015
Risk Score for Predicting Mortality in Flail Chest.
СтатьяНазвание и аннотация: Перевод в очереди
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Zehr Meaghan, Klar Neil, Malthaner Richard A
Аннотация
BACKGROUND: Flail chest injuries are associated with high mortality and morbidity. Despite evidence that operative repair of flail chest is beneficial, it is rarely done. We sought to create a simple risk score using available preoperative covariates to calculate individual risk of mortality in flail chest.
METHODS: A logistic regression model was trained on Ontario Trauma Registry data to generate a mortality risk score. The final model was validated for calibration and discrimination and corrected for optimism.
RESULTS: The model uses five risk factors that are readily obtained during the initial assessment of the trauma patient: age, Glasgow Coma Score, ventilation, cardiopulmonary resuscitation, and number of comorbidities. It was determined that less than 6 points is consistent with 1% observed mortality, 6 to 10 points predicts 5% mortality, 11 to 15 points predicts 22% mortality, and 16 or more points predicts 46% mortality.
CONCLUSIONS: We have developed a simple model that can be easily applied at bedside to predict mortality in patients with flail chest by accessing a spreadsheet program in an application or other handheld computer device. This model has the potential to be a useful tool for surgeons considering operative repair of flail chest.
METHODS: A logistic regression model was trained on Ontario Trauma Registry data to generate a mortality risk score. The final model was validated for calibration and discrimination and corrected for optimism.
RESULTS: The model uses five risk factors that are readily obtained during the initial assessment of the trauma patient: age, Glasgow Coma Score, ventilation, cardiopulmonary resuscitation, and number of comorbidities. It was determined that less than 6 points is consistent with 1% observed mortality, 6 to 10 points predicts 5% mortality, 11 to 15 points predicts 22% mortality, and 16 or more points predicts 46% mortality.
CONCLUSIONS: We have developed a simple model that can be easily applied at bedside to predict mortality in patients with flail chest by accessing a spreadsheet program in an application or other handheld computer device. This model has the potential to be a useful tool for surgeons considering operative repair of flail chest.