Development of a novel tool to predict pulmonary complications in trauma patients with and without chest injury

Abstract

BackgroundExisting chest trauma scoring tools are often only applicable to patients with chest trauma. We sought to develop a novel Trauma Induced Pulmonary Event (TIPE) score to predict the risk of developing pulmonary complications in all adult trauma patients. MethodsMultiple logistic regression models were created using the 2017 Trauma Quality Improvement Program (TQIP) to identify independent predictors of pulmonary complications in trauma patients. The weighted average and relative impact of each independent predictor was used to derive a TIPE score. We then validated the score using area under the receiver operating curve (AROC). ResultsA total of 22 independent predictors of pulmonary complications were identified. The TIPE score was derived with scores ranging from 0 to 43. Injury accounted for 74% of the total score while comorbidities and demographics made up 21% and 5%, respectively. The most important individual predictors were injuries to the spinal cord and bile ducts (both 4 points). The AROC for this was 0.844. DiscussionTIPE is a novel scoring tool to help predict pulmonary complications in all trauma patients.