Two Prognostic Indices for the Trauma Patient,
EDGEWOOD ARSENAL ABERDEEN PROVING GROUND MD
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A number of pattern recognition techniques have been used to determine compact physiological and biochemical indices which quantitatively characterized post-traumatic states. These indices frequently characterize the patient more accurately than physicians. The paper reports on two indices. A trauma index called the CHOP index based on serum creatinine, hematocrit, serum osmolality, and systolic blood pressure, evolved from a retrospective and then a prospective analysis of over 700 patients. A decision rule which predicts death or survival resulted in a misclassification rate of less than 10 for patients in the Trauma Unit for more than one day. A respiratory index R.I. which is the alveolar-arterial oxygen difference divided by the arterial partial pressure of oxygen was investigated in a retrospective study of 177 consecutive intubated patients. All patients with an R.I. of two or greater were intubated. Patients with an R.I. over six had a 12 chance of survival. Prognosis regions are specified in the space determined by the two indices. A nomogram which allows one to follow the course of a patient with respiratory problems is described.
- Medicine and Medical Research