https://nova.newcastle.edu.au/vital/access/ /manager/Index en-au 5 https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:20386 15, age > 18 years, head Abbreviated Injury Scale [AIS] score < 3, survival for >48 hours). Demographics, ISS, physiologic parameters, SOFA and Denver scores, and outcome data were prospectively collected. Sensitivity/specificity and receiver operating characteristic curve were calculated for both scores. Analysis was also completed for a Day 3 postinjury SOFA and Denver score. Results: A total of 140 patients met the inclusion criteria (mean [SD] age, 47 [21] years; ISS, 30; male, 69%; mortality rate, 6%; mean [SD] ICU LOS, 9 [7] days; mean [SD] ventilation period, 6 [7] days). There was no difference in the score performance predicting mortality. Day 3 SOFA score of 4 or greater outperformed the Denver score of greater than 3 when predicting ICU LOS and ventilator days (area under the curve, 0.83 vs. 0.69, 0.86 vs. 0.73, respectively). The SOFA score was more sensitive and the Denver score was more specific when predicting mortality, ICU LOS, and ventilator days. Conclusion: Both scores had similar performance predicting mortality; however, the Day 3 SOFA score outperforms the Denver score when predicting ICU LOS and ventilator days. Either score could be superior based on whether one is seeking to optimize specificity or sensitivity. It is important to note that these findings are in a non–head-injured population and that there are practical difficulties using the SOFA in head-injured patients.]]> Sat 24 Mar 2018 07:58:08 AEDT ]]> https://nova.newcastle.edu.au/vital/access/ /manager/Repository/uon:19721 15; age > 18 years, head Abbreviated Injury Scale [AIS] score < 3; and survival for >48 hours). Demographics, injury severity (ISS), physiologic parameters, MOF status based on the Denver score, and outcome data were prospectively collected. Univariate analysis and multivariate logistic modeling were performed; p < 0.05 was considered significant. Data are presented as percentage or mean (SD). RESULTS: A total of 140 patients met the inclusion criteria (age, 47 [21] years; ISS, 30 [11]; male, 69%), 21 patients (15%) developed MOF, and MOF associated mortality was 24% versus non-MOF mortality rate of 3%. Patients who developed MOF had longer ICU stays (19 [7] vs. 7 [5], p < 0.01) and had more ventilator days (18 [9] vs. 4 [4], p < 0.01). Prediction models were generated at two time points as follows: admission and 24 hours after injury. At admission, age (>65 years) and admission platelet count (<150 ✕ 10(9)/L) were significant predictors of MOF; at 24 hours after injury, MOF was predicted by age more than 65 years, admission platelet count less than 150 ✕ 10(9)/L, maximum creatinine of greater than 150 ✕ 10(9)/L and minimum bilirubin of greater than 10 ✕ 10(9)/L. Shock parameters and injury severity did not predict MOF. CONCLUSION: The incidence of MOF (15%) is lower than reported 15 years ago; MOF remains a major cause of ICU resource use and late mortality after injury. The independent predictors of MOF have fundamentally changed, likely owing to improvements in resuscitation and critical care. Current predictors are universally available at admission and 24 hours. LEVEL OF EVIDENCE: Epidemiologic/prognostic study, level III.]]> Sat 24 Mar 2018 07:53:43 AEDT ]]>