| Acute respiratory distress syndrome after trauma: development and validation of a predictive model. | |
| | |
MedLine Citation:
|
PMID: 22809905 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: To determine early clinical predictors of acute respiratory distress syndrome after major traumatic injury and characterize the performance of this acute respiratory distress syndrome prediction model, and two previously published acute respiratory distress syndrome prediction models, in an independent cohort of severely injured patients. DESIGN: Prospective cohort study. SETTING: University-affiliated level I trauma center in Seattle, WA, and nine hospitals participating in the Inflammation and Host Response to Injury Consortium. PATIENTS: Model derivation utilized data from 224 patients participating in a randomized controlled trial. All models were validated in an independent cohort of 1,762 trauma patients. MEASUREMENTS AND MAIN RESULTS: Variables strongly associated with acute respiratory distress syndrome in bivariate analysis (p<.01) were entered into a multiple logistic regression equation to generate an acute respiratory distress syndrome predictive model. We evaluated the performance of all models using the area under the receiver operator characteristic curve. Acute respiratory distress syndrome occurred in 79 subjects (35%) belonging to the development cohort and in 423 subjects (24%) from the validation cohort. Multivariable predictors of acute respiratory distress syndrome after trauma included subject age, Acute Physiology and Chronic Health Evaluation II Score, injury severity score, and the presence of blunt traumatic injury, pulmonary contusion, massive transfusion, and flail chest injury (area under the receiver operator characteristic curve 0.79 [95% confidence interval 0.73, 0.85]). Validation of the prediction model resulted in an area under the receiver operator characteristic curve of 0.71 (95% confidence interval 0.68, 0.74). Our model's performance in the validation cohort was superior to that of two other published acute respiratory distress syndrome prediction models (0.65 [95% confidence interval 0.63, 0.68] and 0.66 [95% confidence interval 0.64, 0.69], p<.01 for all comparisons). CONCLUSIONS: Using routinely available clinical data, our prediction model identifies patients at high risk for acute respiratory distress syndrome early after severe traumatic injury. This predictive model could facilitate enrollment of subjects into future clinical trials designed to prevent this serious complication. |
| | |
Authors:
|
Timothy R Watkins; Avery B Nathens; Colin R Cooke; Bruce M Psaty; Ronald V Maier; Joseph Cuschieri; Gordon D Rubenfeld |
Related Documents
:
|
1990735 - The painful shoulder: part ii. intrinsic disorders and impingement syndrome. 22767365 - Horner's syndrome with epidural anaesthesia. 22796475 - Audiometric characteristics of two dutch families with non-ocular stickler syndrome (co... 11937145 - Postparacentesis bilateral massive vulvar edema in a patient with severe ovarian hypers... 22043435 - Familial ectrodactyly syndrome in a nigerian child: a case report. 3021645 - The role of renal prostaglandin e as a possible modulator of cyclic amp production in n... |
Publication Detail:
|
Type: Journal Article; Research Support, N.I.H., Extramural |
Journal Detail:
|
Title: Critical care medicine Volume: 40 ISSN: 1530-0293 ISO Abbreviation: Crit. Care Med. Publication Date: 2012 Aug |
Date Detail:
|
Created Date: 2012-07-19 Completed Date: 2012-10-03 Revised Date: 2013-04-16 |
Medline Journal Info:
|
Nlm Unique ID: 0355501 Medline TA: Crit Care Med Country: United States |
Other Details:
|
Languages: eng Pagination: 2295-303 Citation Subset: AIM; IM |
Affiliation:
|
Research Institute, Puget Sound Blood Center, Seattle, WA, USA. timw@medicine.washington.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
APACHE Adult Age Factors Blood Transfusion / adverse effects Female Humans Injury Severity Score Logistic Models Male Middle Aged Models, Biological Prospective Studies ROC Curve Reproducibility of Results Respiratory Distress Syndrome, Adult / etiology* Thoracic Injuries / complications Wounds and Injuries / complications* Wounds, Nonpenetrating / complications |
| Grant Support | |
ID/Acronym/Agency:
|
F32 HL090166/HL/NHLBI NIH HHS; F32HL090166-01/HL/NHLBI NIH HHS; K23 GM086729/GM/NIGMS NIH HHS; K23GM086729/GM/NIGMS NIH HHS; U54-GM062119/GM/NIGMS NIH HHS |
| Comments/Corrections | |
Comment In:
|
Crit Care Med. 2012 Aug;40(8):2497-8
[PMID:
22809919
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Persistent peripheral and microcirculatory perfusion alterations after out-of-hospital cardiac arres...
Next Document: Procalcitonin usefulness for the initiation of antibiotic treatment in intensive care unit patients.