Prediction of postinjury multiple-organ failure in the emergency department

• DOI: 10.1097/ta.0b013e3182a99da4
• Publication Date: 2013-12-24T10:57:33Z
• Authors: Jody A. Vogel; Michael M. Liao; Emily Hopkins; Nicole Seleno; Richard L. Byyny; Ernest E. Moore; Craig Gravitz; Jason S. Haukoos
• Keywords: Interquartile range; Blunt trauma

Multiple-organ failure (MOF) is common among the most seriously injured trauma patients. The ability to easily and accurately identify patients in emergency department at risk for MOF would be valuable. aim of this study was derive internally validate an instrument predict development adult using clinical laboratory data available department.We enrolled consecutive from 2005 2008 Denver Health Trauma Registry, a prospectively collected database urban Level 1 center. Multivariable logistic regression used develop prediction instrument. outcome within 7 days admission as defined by Sequential Organ Failure Assessment (SOFA) score. A score created final model rounding β coefficients nearest integer. Calibration discrimination were assessed 10-fold cross-validation.A total 4,355 included study. median age 37 years (interquartile range [IQR], 26-51 years), 72% male. Injury Severity Score (ISS) 9 (IQR, 4-16), 78% had blunt injury mechanisms. occurred 216 (5%; 95% confidence interval, 4-6%). patient age, intubation, systolic blood pressure, hematocrit, urea nitrogen, white cell count ranged 0 9. prevalence increased approximate exponential fashion increased. demonstrated excellent calibration (calibration slope, 1.0; c statistic, 0.92).We derived simple, valid adults following trauma. use may allow early identification result more aggressive targeted resuscitation improved resource allocation.Prognostic epidemiologic study, level III.