Multivariable analysis of predictors for acute respiratory distress syndrome in patients with major (ISS >16) vs. minor (ISS ≤15) trauma
OR | 95% CI | P value | |
Demographics | |||
Age | |||
16–25 | Baseline | ||
26–45 | 1.0 | 0.87 to 1.07 | 0.5 |
46–65 | 0.83 | 0.74 to 0.92 | <0.001 |
66–75 | 0.80 | 0.68 to 0.93 | 0.01 |
>75 | 0.75 | 0.63 to 0.9 | <0.001 |
Male | 1.14 | 1.05 to 1.2 | <0.001 |
Race | |||
White | Baseline | ||
Black | 1.11 | 1.001 to 1.21 | 0.05 |
Hispanic or Latino | 0.98 | 0.82 to 1.18 | 0.9 |
Other | 1.09 | 0.95 to 1.25 | 0.2 |
Insurance | |||
Medicaid | Baseline | ||
Medicare | 0.76 | 0.66 to 0.87 | <0.001 |
Private | 1.12 | 0.97 to 1.29 | 0.1 |
Self-pay | 0.93 | 0.82 to 1.05 | 0.2 |
Extrathoracic risk factors | |||
EtOH | |||
No-confirmed | Baseline | ||
Not tested | 0.56 | 0.51 to 0.61 | <0.001 |
Below 0.08 | 0.86 | 0.74 to 0.99 | 0.04 |
Above 0.08 | 0.79 | 0.71 to 0.89 | <0.001 |
Drugs | |||
No-confirmed | Baseline | ||
Not tested | 0.84 | 0.75 to 0.95 | 0.01 |
Yes-prescription | 0.73 | 0.62 to 0.87 | <0.001 |
Yes-illegal | 0.87 | 0.78 to 0.97 | 0.02 |
Lowest ED systolic blood pressure | 0.99 | 0.99 to 0.99 | <0.001 |
Temperature | 0.93 | 0.91 to 0.95 | <0.001 |
GCS motor score | 0.78 | 0.76 to 0.79 | <0.001 |
Thoracic risk factors | |||
Trauma-induced lung contusion | 2.16 | 1.96 to 2.38 | <0.001 |
Traumatic rib fracture | |||
No rib fractures | Baseline | ||
1 rib fracture | 2.20 | 1.89 to 2.56 | <0.001 |
2 rib fractures | 1.80 | 1.55 to 2.07 | <0.001 |
3 rib fractures | 1.69 | 1.43 to 1.98 | <0.001 |
4 rib fractures | 2.30 | 1.88 to 2.8 | <0.001 |
5 rib fractures | 3.40 | 2.8 to 4.1 | <0.001 |
6 rib fractures | 3.49 | 2.7 to 4.44 | <0.001 |
7 rib fractures | 3.42 | 2.63 to 4.44 | <0.001 |
≥8 rib fractures | 4.41 | 3.23 to 6.01 | <0.001 |
Rib fracture (NOS) | 5.36 | 4.40 to 6.51 | <0.001 |
Flail chest | 8.48 | 6.33 to 11.34 | <0.001 |
Comorbidities | |||
Alcoholism | 0.71 | 0.64 to 0.78 | <0.001 |
Bleeding disorder | 1.28 | 1.13 to 1.44 | <0.001 |
Congestive heart failure | 0.69 | 0.59 to 0.79 | <0.001 |
Current smoker | 0.87 | 0.78 to 0.96 | 0.01 |
Diabetes mellitus | 0.99 | 0.89 to 1.08 | 0.77 |
History of angina within 30 days | 0.88 | 0.66 to 1.15 | 0.36 |
History of myocardial infarction | 0.76 | 0.62 to 0.91 | <0.001 |
Hypertension requiring medications | 0.87 | 0.8 to 0.94 | <0.001 |
Obesity | 0.82 | 0.73 to 0.91 | <0.001 |
History of respiratory disease | 0.60 | 0.55 to 0.66 | <0.001 |
ED, emergency department; EtOH, pre-injury alcohol consumption; GCS, Glasgow Coma Scale; ISS, Injury Severity Score; NOS, not otherwise specified.