Forecasting of the course and outcome of shock in severe mechanical traumas.

The ability to forecast the course and outcome of severe mechanical trauma would aid clinicians in making decisions concerning the treatment of patients. Multifactorial regression models, developed from data obtained from 933 patients with polytrauma and shock, have a high predictive value. A two-part data sheet was developed to give a rating system that predicts the duration of shock in patients that survive and the life span in patients that eventually die. Factors considered in developing the rating system include systemic hemodynamics, hematocrit number, blood density, arteriovenous difference in oxygen saturation, and rectocutaneous temperature gradient, among others.

[The system of evaluation of the severity of injuries (status and prospects of the problem)]. / Sistema otsenki tiazhesti travm (sostoianie i perspektivy problemy).

The authors have substantiated the necessity of elaboration and introduction of a single all-state++ system of objective quantitative evaluation of the severity of the injuries. A brief comparative characteristic of the most popular Soviet and foreign systems of the severity of the injuries is presented. The synthesized scales (elaborated at the prognosis laboratory of the Central Institute of Traumatology and Orthopedics ) for a quantitative evaluation of the character and the localization of the fractures are presented.

[The objective assessment of the determination of the period of unstable hemodynamics in traumatic shock]. / Ob''ektivizatsiia opredeleniia perioda nestabil'noi gemodinamiki pri travmaticheskom shoke.

It was established that the moment when patients revive from traumatic shock can be objectified from analysis of time series trends. The author shows the expediency of differentiating the concept "stability of hemodynamics" into stably deteriorating and stably nondeteriorating dynamics of the values of systemic hemodynamics. The possibility of prognosticating the quantitative characteristics of circulation parameters for a certain preset period of time was revealed.

[Prediction of the nature of the course and outcome of shock in multiple trauma based on a mathematical analysis of heart rhythm]. / Prognozirovanie kharaktera techeniia i iskhodov shoka pri politravme na osnove matematicheskogo analiza ritma serdtsa.

As the result of research an expanded scale for evaluating the shock-producing property of traumas in marks was created. The cardiac interval measurement values were found to be of high prognostic value. Regressive models of traumatic shock outcome were obtained on the basis of statistic characteristics of heart rhythm. It is shown that the prognosis models may be more effective with the use of alternating switches.