Clinical and biostatistical approach to assessing the severity of physical status of patients with combined midface trauma. Part 2

Abstract

Objective. To develop a method for predicting mortality among patients with combined midface trauma (CMFT). Materials and methods. This study is based on the examination results of 95 patients with CMFT. Depending on the outcome of CMFT, 2 groups of patients were formed: the first group – patients with a favorable outcome (n=50); the second group – patients with an unfavorable outcome (n=45). A group of physiological parameters was measured on the 1st, 3rd, 7th and 14th days of patients’ hospital stays. The creation of the CMFT outcomes predicting method was carried out using factor analysis (principal component method) and discriminant analysis. Results. The CMFT outcomes predicting method has been developed in two variants. The first variant (with parameters of the blood gas test) includes the following parameters: leukocyte index of intoxication according to Ya.Ya. Kalf-Kalifu (LII), blood glucose level, concentration of potassium ions in the blood (K+), international normalized ratio, partial pressure of carbon dioxide in arterial blood, partial pressure of oxygen in arterial blood, measured on the 3rd day after injury, and also the age of the patient, evidence of cardiovascular diseases in patient’s medical history and the occurrence of cerebral edema after the injury. The second variant (without the parameters of the blood gas test) includes the following parameters: absolute number of leukocytes (on the 1st day after injury), LII, K+, blood urea level, absolute number of lymphocytes, measured on the 3rd day after injury, as well as patient’s age, evidence of cardiovascular diseases in patient’s medical history and the occurrence of cerebral edema after injury. The classification accuracy when using the first variant was 100%, the second variant – 98.4%. Conclusions. Taking into account the set of variables included in our study, and based on the results of this study published in the first and in this part of this article, we can conclude that the optimal time point for predicting the CMFT outcomes is the 3rd day after injury. The method for predicting the CMFT short-term outcomes developed in our study can be used in determining the timing for reconstructive surgery as part of the damage control surgery treatment of patients with this pathology.