Tissue damage volume predicts organ dysfunction and inflammation after injury

Area of Science:

• Trauma surgery
• Medical imaging analysis
• Critical care medicine

Background:

• Multiply injured patients (MIPs) face risks of multiple-organ failure (MOF) and prolonged systemic inflammation response syndrome (SIRS).
• Predicting which MIPs are most susceptible to these complications remains challenging.
• A novel Tissue Damage Volume (TDV) score quantifies injury magnitude and distribution from CT scans.

Purpose of the Study:

• To explore the correlation between individualized TDV scores and the development of MOF and SIRS in MIPs.
• To assess the predictive value of TDV in identifying high-risk patients.

Main Methods:

• Retrospective analysis of 74 MIPs.
• Measurement of mechanical TDV by calculating injury volumes from admission CT scans across head/neck, chest, abdomen, and pelvis.
• Comparison of regional and total TDV scores between patients with and without MOF or SIRS.

Main Results:

• Significantly increased mean total and pelvic TDV scores in patients who developed MOF.
• Elevated mean total, chest, and abdominal TDV scores in patients with sustained SIRS.
• Greater organ dysfunction magnitude correlated with large-volume injuries (pelvis/abdomen) or injuries in ≥3 anatomic regions.

Conclusions:

• The TDV score is a patient-specific index quantifying mechanical tissue damage, capable of predicting progression to MOF and SIRS.
• This novel index aids in identifying injury patterns associated with adverse outcomes.
• Preliminary findings require refinement and prospective validation.