BACKGROUND: The ability to easily predict the need for massive transfusion may improve the process of care, allowing early mobilization of resources. There are currently no clear criteria to activate massive transfusion in severely injured trauma patients. The aims of this study were to create a scoring system to predict the need for massive transfusion and then to validate this scoring system. METHODS: We reviewed the records of 119 severely injured trauma patients and identified massive transfusion predictors using statistical methods. Each predictor was converted into a simple score based on the odds ratio in a multivariate logistic regression analysis. The Traumatic Bleeding Severity Score (TBSS) was defined as the sum of the component scores. The predictive value of the TBSS for massive transfusion was then validated, using data from 113 severely injured trauma patients. Receiver operating characteristic curve analysis was performed to compare the results of TBSS with the Trauma-Associated Severe Hemorrhage score and the Assessment of Blood Consumption score. RESULTS: In the development phase, five predictors of massive transfusion were identified, including age, systolic blood pressure, the Focused Assessment with Sonography for Trauma scan, severity of pelvic fracture, and lactate level. The maximum TBSS is 57 points. In the validation study, the average TBSS in patients who received massive transfusion was significantly greater (24.2 [6.7]) than the score of patients who did not (6.2 [4.7]) (p < 0.01). The area under the receiver operating characteristic curve, sensitivity, and specificity for a TBSS greater than 15 points was 0.985 (significantly higher than the other scoring systems evaluated at 0.892 and 0.813, respectively), 97.4%, and 96.2%, respectively. CONCLUSION: The TBSS is simple to calculate using an available iOS application and is accurate in predicting the need for massive transfusion. Additional multicenter studies are needed to further validate this scoring system and further assess its utility. LEVEL OF EVIDENCE: Prognostic study, level III.
BACKGROUND: The ability to easily predict the need for massive transfusion may improve the process of care, allowing early mobilization of resources. There are currently no clear criteria to activate massive transfusion in severely injured traumapatients. The aims of this study were to create a scoring system to predict the need for massive transfusion and then to validate this scoring system. METHODS: We reviewed the records of 119 severely injured traumapatients and identified massive transfusion predictors using statistical methods. Each predictor was converted into a simple score based on the odds ratio in a multivariate logistic regression analysis. The Traumatic Bleeding Severity Score (TBSS) was defined as the sum of the component scores. The predictive value of the TBSS for massive transfusion was then validated, using data from 113 severely injured traumapatients. Receiver operating characteristic curve analysis was performed to compare the results of TBSS with the Trauma-Associated Severe Hemorrhage score and the Assessment of Blood Consumption score. RESULTS: In the development phase, five predictors of massive transfusion were identified, including age, systolic blood pressure, the Focused Assessment with Sonography for Trauma scan, severity of pelvic fracture, and lactate level. The maximum TBSS is 57 points. In the validation study, the average TBSS in patients who received massive transfusion was significantly greater (24.2 [6.7]) than the score of patients who did not (6.2 [4.7]) (p < 0.01). The area under the receiver operating characteristic curve, sensitivity, and specificity for a TBSS greater than 15 points was 0.985 (significantly higher than the other scoring systems evaluated at 0.892 and 0.813, respectively), 97.4%, and 96.2%, respectively. CONCLUSION: The TBSS is simple to calculate using an available iOS application and is accurate in predicting the need for massive transfusion. Additional multicenter studies are needed to further validate this scoring system and further assess its utility. LEVEL OF EVIDENCE: Prognostic study, level III.
Authors: Ladislav Mica; Cedric Niggli; Peter Bak; Avi Yaeli; Margaret McClain; Charles M Lawrie; Hans-Christoph Pape Journal: World J Surg Date: 2020-03 Impact factor: 3.352
Authors: Cheng-Shyuan Rau; Shao-Chun Wu; Spencer C H Kuo; Kuo Pao-Jen; Hsu Shiun-Yuan; Yi-Chun Chen; Hsiao-Yun Hsieh; Ching-Hua Hsieh; Hang-Tsung Liu Journal: Int J Environ Res Public Health Date: 2016-07-05 Impact factor: 3.390
Authors: Kirsten Balvers; Michiel Coppens; Susan van Dieren; Ingeborg H M van Rooyen-Schreurs; Henriëtte J Klinkspoor; Sacha S Zeerleder; Holger M Baumann; J Carel Goslings; Nicole P Juffermans Journal: J Emerg Trauma Shock Date: 2015 Oct-Dec
Authors: Hao Wang; Johnbosco Umejiego; Richard D Robinson; Chet D Schrader; JoAnna Leuck; Michael Barra; Stefan Buca; Andrew Shedd; Andrew Bui; Nestor R Zenarosa Journal: J Clin Med Res Date: 2016-07-01