Assessing Mortality of Blunt Trauma with Co-morbidity

TL;DR

This paper introduces a new entropy-based morbidity measure, the Abbreviated Morbidity Scale (AMS), to better estimate mortality in blunt trauma patients, especially considering co-morbidities and vulnerable populations.

Contribution

It develops an entropy-based morbidity measure extending the Injury Severity Score to include co-morbidities, improving mortality assessment accuracy.

Findings

AMS correlates well with existing trauma measures

Co-morbidity significantly affects mortality at lower injury levels

Elderly patients have higher mortality risk due to co-morbidities

Abstract

Objectives: To obtain a better estimate of the mortality of individuals suffering from blunt force trauma, including co-morbidity. Methodology: The Injury severity Score (ISS) is the default world standard for assessing the severity of multiple injuries. ISS is a mathematical fit to empirical field data. It is demonstrated that ISS is proportional to the Gibbs/Shannon Entropy. A new Entropy measure of morbidity from blunt force trauma including co-morbidity is derived based on the von Neumann Entropy, called the Abbreviated Morbidity Scale (AMS). Results: The ISS trauma measure has been applied to a previously published database, and good correlation has been achieved. Here the existing trauma measure is extended to include the co-morbidity of disease by calculating an Abbreviated Morbidity Score (AMS), which encapsulates the disease co-morbidity in a manner analogous to AIS, and on a consistent Entropy base. Applying Entropy measures to multiple injuries, highlights the role of co-morbidity and that the elderly die at much lower levels of injury than the general population, as a consequence of co-morbidity. These considerations lead to questions regarding current new car assessment protocols, and how well they protect the most vulnerable road users. Keywords: Blunt Force Trauma, Injury Severity Score, Co-morbidity, Entropy.