Penetrating chest injury: Who warrants aggressive treatment?

To determine the degree of severity in penetrating chest injuries that predicts survival, we conducted a logistic regression analysis. All patients suffering penetrating chest injuries (n = 310) admitted to an urban level I teaching hospital in the USA between January 1993 and December 1994 were evaluated. The Injury Severity Score (ISS), Glasgow Goma-Scale (GCS), Trauma Score (TS), and Revised Trauma Score were used to compare injury survivors with nonsurvivors. We used the trauma scores to create a logit to predict the outcome among-160 patients in 1993 and tested the validity of this logitsin- another 150 patients in 1994. With death = 0, survival = 1, the equation=in P(d)/P(s) b0 + b1 ISS + b (t) GCS + B9 TS was obtained from logistic regression where b0 was the constant of the equation and b1, b2, and b3 were the coefficients of = ISS, GCS and TS, respectively. A logic score- greater than 0.5 was found to be predictive of death was a sensitivity of 80.0%, a specificity of 97.5% and an accuracy of 94.0%. Aggressive resuscitation should be aimed at patients with a logit score greater than 0.5 to reduce mortality. This knowledge may aid in the management of patients, with: severe, chest injuries.