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J Crit Care. 2013 Dec;28(6):1109.e1-4. doi: 10.1016/j.jcrc.2013.08.026. Epub 2013 Oct 10.

Real-time sample entropy predicts life-saving interventions after the Boston Marathon bombing.

Author information

1
Department of Surgery, Division of Trauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.

Abstract

PURPOSE:

Identifying patients in need of a life-saving intervention (LSI) during a mass casualty event is a priority. We hypothesized that real-time, instantaneous sample entropy (SampEn) could predict the need for LSI in the Boston Marathon bombing victims.

MATERIALS AND METHODS:

Severely injured Boston Marathon bombing victims (n = 10) had sample entropy (SampEn) recorded upon presentation using a continuous 200-beat rolling average in real time. Treating clinicians were blinded to real-time results. The correlation between SampEn, injury severity, number, and type of LSI was examined.

RESULTS:

Victims were males (60%) with a mean age of 39.1 years. Injuries involved lower extremities (50.0%), head and neck (24.2%), or upper extremities (9.7%). Sample entropy negatively correlated with Injury Severity Score (r = -0.70; P = .023), number of injuries (r = -0.70; P = .026), and the number and need for LSI (r = -0.82; P = .004). Sample entropy was reduced under a variety of conditions. (Table see text).

CONCLUSIONS:

Sample entropy strongly correlates with injury severity and predicts LSI after blast injuries sustained in the Boston Marathon bombings. Sample entropy may be a useful triage tool after blast injury.

KEYWORDS:

Bleeding; Bombing; Entropy; Trauma

PMID:
24120576
DOI:
10.1016/j.jcrc.2013.08.026
[Indexed for MEDLINE]
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