Examination of Pneumonia Risks and Risk Levels in Trauma Patients With Pulmonary Contusion

Landeen, Carolina; Smith, Hayden L.

doi:10.1097/jtn.0000000000000029

Cited by 8 publications

(16 citation statements)

References 18 publications

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“…Elevated pneumonia risk has been well documented in patients requiring mechanical ventilation, and multiple studies have outlined this increased risk in subjects who suffered significant trauma. 10,[17][18][19][20] Additionally, higher VAP rates have been associated with the presence of pulmonary contusions. 19,21 We saw a relatively high VAP rate in both groups of our study.…”

Section: Discussionmentioning

confidence: 99%

“…4,8,9 Prior studies have failed to isolate pulmonary contusion as the causative agent of worsened outcomes among those with severe injuries because of the prevalence of concurrent traumatic injury. 10 With severe thoracic injury, it is difficult to discern whether the unwanted sequelae are secondary to thoracic injury or to the underlying lung injury SEE THE RELATED EDITORIAL ON PAGE 1073 specifically. We sought to evaluate the outcomes of mechanically ventilated patients with severe thoracic injuries, with and without pulmonary contusion, and hypothesized that contusion would not increase morbidity.…”

Section: Introductionmentioning

confidence: 99%

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Pulmonary Contusion in Mechanically Ventilated Subjects After Severe Trauma

et al. 2018

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pulmonary Contusion in Mechanically Ventilated Subjects After Severe Trauma

et al. 2018

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“…1,3,8,40 Pneumonia in pulmonary contusions increases the mortality rate. 8 Mechanical ventilation also increases mortality and morbidity in patients with ARDS. 23 Although this is an interesting topic, not many studies dealt with this treatment so far.…”

Section: Discussionmentioning

confidence: 99%

Exogenous surfactant for lung contusion causing ARDS: A systematic review of clinical and experimental reports

Merkl,

Astapenko,

Štichhauer

et al. 2024

Clinical Respiratory J

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This systematic review aimed to summarize the available data on the treatment of pulmonary contusions with exogenous surfactants, determine whether this treatment benefits patients with severe pulmonary contusions, and evaluate the optimal type of surfactant, method of administration, and drug concentration. Three databases (MEDline, Scopus, and Web of Science) were searched using the following keywords: pulmonary surfactant, surface‐active agents, exogenous surfactant, pulmonary contusion, and lung contusion for articles published between 1945 and February 2023, with no language restrictions. Four reviewers independently rated the studies for inclusion, and the other four reviewers resolved conflicts. Of the 100 articles screened, six articles were included in the review. Owing to the limited number of papers on this topic, various types of studies were included (two clinical studies, two experiments, and two case reports). In all the studies, surfactant administration improved the selected ventilation parameters. The most frequently used type of surfactant was Curosurf® in the concentration of 25 mg/kg of ideal body weight. In most studies, the administration of a surfactant by bronchoscopy into the segmental bronchi was the preferable way of administration. In both clinical studies, patients who received surfactants required shorter ventilation times. The administration of exogenous surfactants improved ventilatory parameters and, thus, reduced the need for less aggressive artificial lung ventilation and ventilation days. The animal‐derived surfactant Curosurf® seems to be the most suitable substance; however, the ideal concentration remains unclear. The ideal route of administration involves a bronchoscope in the segmental bronchi.

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“…Predictive modelling to aid clinical decision-making is not a new concept. The Scoring System for Pneumonia Risk in Pulmonary Contusion Patients, the "RibScore", a novel radiographic score based on fracture patterns, and the Clinical Pulmonary Infection Score (CPIS) are all examples of current operational scoring tools (8,11,12). The CPIS tool has shown moderate reliability and accuracy in diagnosing nosocomial pneumonia (33,34).…”

Section: Discussionmentioning

confidence: 99%

“…The Clinical Pulmonary Infection Score (CPIS) has been proposed and used clinically for decades and has shown some shortcomings in guiding the management of pneumonia (8). Consequently, many studies have been conducted to design and construct more accurate and stable risk scores, such as the Scoring System for Pneumonia Risk in Pulmonary Contusion Patients (11) and "RibScore", a novel radiographic score based on fracture patterns, have been performed (12). These prediction models have been developed based on a generalised linear approach; in addition, the "RibScore" only considers anatomical factors (13).…”

Section: Introductionmentioning

confidence: 99%

Predicting pneumonia during hospitalization in flail chest patients using machine learning approaches

Song

Chen

et al. 2023

Front. Surg.

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ObjectivePneumonia is a common pulmonary complication of flail chest, causing high morbidity and mortality rates in affected patients. The existing methods for identifying pneumonia have low accuracy, and their use may delay antimicrobial therapy. However, machine learning can be combined with electronic medical record systems to identify information and assist in quick clinical decision-making. Our study aimed to develop a novel machine-learning model to predict pneumonia risk in flail chest patients.MethodsFrom January 2011 to December 2021, the electronic medical records of 169 adult patients with flail chest at a tertiary teaching hospital in an urban level I Trauma Centre in Chongqing were retrospectively analysed. Then, the patients were randomly divided into training and test sets at a ratio of 7:3. Using the Fisher score, the best subset of variables was chosen. The performance of the seven models was evaluated by computing the area under the receiver operating characteristic curve (AUC). The output of the XGBoost model was shown using the Shapley Additive exPlanation (SHAP) method.ResultsOf 802 multiple rib fracture patients, 169 flail chest patients were eventually included, and 86 (50.80%) were diagnosed with pneumonia. The XGBoost model performed the best among all seven machine-learning models. The AUC of the XGBoost model was 0.895 (sensitivity: 84.3%; specificity: 80.0%).Pneumonia in flail chest patients was associated with several features: systolic blood pressure, pH value, blood transfusion, and ISS.ConclusionOur study demonstrated that the XGBoost model with 32 variables had high reliability in assessing risk indicators of pneumonia in flail chest patients. The SHAP method can identify vital pneumonia risk factors, making the XGBoost model's output clinically meaningful.

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Examination of Pneumonia Risks and Risk Levels in Trauma Patients With Pulmonary Contusion

Cited by 8 publications

References 18 publications

Pulmonary Contusion in Mechanically Ventilated Subjects After Severe Trauma

Pulmonary Contusion in Mechanically Ventilated Subjects After Severe Trauma

Exogenous surfactant for lung contusion causing ARDS: A systematic review of clinical and experimental reports

Predicting pneumonia during hospitalization in flail chest patients using machine learning approaches

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