Lung Organ Failure Score (LOFS): Probability of severe pulmonary organ failure after multiple injuries including chest trauma
Wutzler S et al. – This scoring method could help trauma surgeons determine which multiple trauma patients are at risk for pulmonary complications after trauma. Efficacy analyses of prophylactic PEEP ventilation or rotational bed therapy in subgroups with comparable risks for respiratory complication could be based on the Lung Organ Failure Score (LOFS).Methods
- Univariate and multivariate logistic regression analyses were used to assess the prognostic value of clinical and laboratory variables (2002–2008; n=30,616) from the Trauma Registry of the German Trauma Society (DGU).
- Data from patients admitted to the ICU with lung contusion/lacerations, an Injury Severity Score ≥16 and age ≥18 were included in the study.
- Severe pulmonary organ failure was defined as PaO2/FiO2<200 for ≥3days and based on the odds ratios (ORs) a simplified Lung Organ Failure Score (LOFS) was developed using integer values.
- 21.3% (1254) of the 5892 patients analysed developed severe pulmonary organ failure.
- The authors identified seven independent predictors with significant correlation: age, gender, head injury, fluid therapy, injury severity, degree of chest trauma and surgical interventions.
- The highest ORs were observed in cases of Abbreviated Injury Scale (AIS)Thorax=5 (1.58), surgical intervention (1.71) and multiple surgeries (2.41).
- They found that patients with simplified score values ≥21 points were at a maximum risk (>30%) for developing severe pulmonary complications.