PREDICTORS OF OUTCOME IN BLUNT DIAGHRAGM RUPTURE

Objective: Identify outcome predictors in blunt diaphragm rupture (BDR ). Design: Retrospective chart and trauma registry review. Materials a nd Methods: We reviewed records of patients with BDR from January 1987 through May 1994 for outcomes of mortality, intensive care unit stay, hospital stay, and ventilator days, Predictors tested were age, sex, Injury Severity Score (ISS), diagnostic delay, rupture side, head inju ry, and associated injuries, Stepwise regression models mere developed and tested on an additional data base of 115 BDR records from four tr auma centers. Results: Thirty-two patients were identified, Age was th e only significant predictor for all outcomes (p < 0.05), Age, ISS, an d severe head injury were mortality predictors, In the larger data bas e, age and ISS remained predictive of mortality, but age was not predi ctive of morbidity. Conclusions: Age and ISS are predictive of BDR mor tality, No morbidity predictor was validated in the larger data base, These data emphasize that predictive models from a single institution should be applied cautiously.