Accuracy of shock index versus ABC score to predict need for massive transfusion in trauma patients

Injury ◽  
2018 ◽  
Vol 49 (1) ◽  
pp. 15-19 ◽  
Author(s):  
Rebecca Schroll ◽  
David Swift ◽  
Danielle Tatum ◽  
Stuart Couch ◽  
Jiselle B. Heaney ◽  
...  
Keyword(s):  
Massive Transfusion ◽  
Trauma Patients ◽  
Shock Index

scholarly journals The Impact of Age and Receipt Antihypertensives to Systolic Blood Pressure and Shock Index at Injury Scene and in the Emergency Department to Predict Massive Transfusion in Trauma Patients

2020 ◽  
Author(s):  
Se Jin Park ◽  
Mi Jin Lee ◽  
Changho Kim ◽  
Haewon Jung ◽  
Seong Hun Kim ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Emergency Department ◽  
Logistic Regression ◽  
Systolic Blood Pressure ◽  
Massive Transfusion ◽  
Red Blood Cell Transfusion ◽  
Trauma Patients ◽  
Shock Index ◽  
Cutoff Value ◽  
The Impact

Abstract Background: Systolic blood pressure (SBP) and shock index (SI) are accurate indicators of hemodynamic instability and the need for transfusion in trauma patients. We aimed to determine whether the utility and cutoff point for SBP and SI are affected by age and antihypertensives. Methods: This was a retrospective observational study of a level 1 trauma center between January 2017 and December 2018. We analyzed the utility and cutoff points of SBP and SI for predicting massive transfusion (MT) and 30-day mortality according to patients’ age and whether they were taking antihypertensives. A multivariable logistic regression analysis was conducted to estimate the association of age and antihypertensives on primary and secondary outcomes. Results: We analyzed 4681 trauma cases. There were 1949 patients aged 65 years or older (41.6%), and 1375 hypertensive patients (29.4%). MT was given to 137 patients (2.9%). The 30-day mortality rate was 6.3% (n = 294). In geriatric trauma patients taking antihypertensives, a prehospital SBP less than 110 mmHg was the cutoff value for predicting MT in multivariate logistic regression analyses; packed red blood cell transfusion volume decreased abruptly based on prehospital SBP of 110 mmHg. Emergency Department SI greater than 1.0 was the cutoff value for predicting MT in patients who were older than 65 years and were not taking antihypertensives. Conclusions: The triage of trauma patients is based on the identification of clinical features readily identifiable by first responders. However, age and medications may also affect the accurate evaluation. In initial trauma management, we must apply SBP and SI differently depending on age, whether a patient is taking antihypertensives, and the time at which the indicators are measured.

scholarly journals Prediction of Massive Transfusion in Trauma Patients with Shock Index, Modified Shock Index, and Age Shock Index

2016 ◽  
Vol 13 (7) ◽  
pp. 683 ◽  
Author(s):  
Cheng-Shyuan Rau ◽  
Shao-Chun Wu ◽  
Spencer Kuo ◽  
Kuo Pao-Jen ◽  
Hsu Shiun-Yuan ◽  
...  
Keyword(s):  
Massive Transfusion ◽  
Trauma Patients ◽  
Shock Index

scholarly journals The Impact of Age and Receipt Antihypertensives to Systolic Blood Pressure and Shock Index at Injury Scene and in the Emergency Department to Predict Massive Transfusion in Trauma Patients

2020 ◽  
Author(s):  
Se Jin Park ◽  
Mi Jin Lee ◽  
Changho Kim ◽  
Haewon Jung ◽  
Seong Hun Kim ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Emergency Department ◽  
Systolic Blood Pressure ◽  
Massive Transfusion ◽  
Geriatric Trauma ◽  
Red Blood Cell Transfusion ◽  
Trauma Patients ◽  
Shock Index ◽  
Cutoff Value ◽  
The Impact

Abstract Background : Systolic blood pressure (SBP) and shock index (SI) are accurate indicators of hemodynamic instability and the need for transfusion in trauma patients. We aimed to determine whether the utility and cutoff point for SBP and SI are affected by age or antihypertensives. Methods : This was a retrospective observational study of a level 1 trauma center between January 2017 and December 2018. We analyzed the utility and cutoff points of SBP and SI for predicting massive transfusion (MT) and 30-day mortality according to patients’ age and whether they were taking antihypertensives. Results : We analyzed 4681 trauma cases. There were 1949 patients aged 65 years or older (41.6%), and 1375 (29.4%) hypertensive patients. MT was given to 137 patients (2.9%). The 30-day mortality rate was 6.3% (n = 294). In geriatric trauma patients taking antihypertensives, prehospital SBP less than 110 mmHg was the cutoff value for predicting MT in multivariate logistic regression analyses; packed red blood cell transfusion volume decreased abruptly based on prehospital SBP of 110 mmHg. Emergency Department SI greater than 1.0 was the cutoff value for the prediction of MT in patients who were older than 65 years who were not taking antihypertensives. Conclusions : The triage of trauma patients is based on the identification of clinical features that are readily identifiable by first responders. However, age and medications may also affect accurate evaluation. In initial trauma management, we must apply SBP and SI differently depending on age, whether a patient is taking antihypertensives, and the time at which the indicators are measured.

Pre-hospital modified shock index for prediction of massive transfusion and mortality in trauma patients

2020 ◽  
Vol 38 (2) ◽  
pp. 187-190 ◽  
Author(s):  
Il-Jae Wang ◽  
Byung-Kwan Bae ◽  
Sung-Wook Park ◽  
Young-Mo Cho ◽  
Dae-Sup Lee ◽  
...  
Keyword(s):  
Massive Transfusion ◽  
Trauma Patients ◽  
Shock Index

scholarly journals The impact of age and receipt antihypertensives to systolic blood pressure and shock index at injury scene and in the emergency department to predict massive transfusion in trauma patients

2021 ◽  
Vol 29 (1) ◽  
Author(s):  
Se Jin Park ◽  
Mi Jin Lee ◽  
Changho Kim ◽  
Haewon Jung ◽  
Seong Hun Kim ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Emergency Department ◽  
Logistic Regression ◽  
Systolic Blood Pressure ◽  
Massive Transfusion ◽  
Red Blood Cell Transfusion ◽  
Trauma Patients ◽  
Shock Index ◽  
Cutoff Value ◽  
The Impact

Abstract Background Systolic blood pressure (SBP) and shock index (SI) are accurate indicators of hemodynamic instability and the need for transfusion in trauma patients. We aimed to determine whether the utility and cutoff point for SBP and SI are affected by age and antihypertensives. Methods This was a retrospective observational study of a level 1 trauma center between January 2017 and December 2018. We analyzed the utility and cutoff points of SBP and SI for predicting massive transfusion (MT) and 30-day mortality according to patients’ age and whether they were taking antihypertensives. A multivariable logistic regression analysis was conducted to estimate the association of age and antihypertensives on primary and secondary outcomes. Results We analyzed 4681 trauma cases. There were 1949 patients aged 65 years or older (41.6%), and 1375 hypertensive patients (29.4%). MT was given to 137 patients (2.9%). The 30-day mortality rate was 6.3% (n = 294). In geriatric trauma patients taking antihypertensives, a prehospital SBP less than 110 mmHg was the cutoff value for predicting MT in multivariate logistic regression analyses; packed red blood cell transfusion volume decreased abruptly based on prehospital SBP of 110 mmHg. Emergency Department SI greater than 1.0 was the cutoff value for predicting MT in patients who were older than 65 years and were not taking antihypertensives. Conclusions The triage of trauma patients is based on the identification of clinical features readily identifiable by first responders. However, age and medications may also affect the accurate evaluation. In initial trauma management, we must apply SBP and SI differently depending on age, whether a patient is taking antihypertensives, and the time at which the indicators are measured.

scholarly journals Disseminated intravascular coagulation immediately after trauma predicts a poor prognosis in severely injured patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Takeshi Wada ◽  
Atsushi Shiraishi ◽  
Satoshi Gando ◽  
Kazuma Yamakawa ◽  
Seitaro Fujishima ◽  
...  
Keyword(s):  
Disseminated Intravascular Coagulation ◽  
Survival Probability ◽  
Poor Prognosis ◽  
Massive Transfusion ◽  
Late Phase ◽  
Hospital Death ◽  
Trauma Patients ◽  
Severely Injured ◽  
Cross Sectional ◽  
Intravascular Coagulation

AbstractTrauma patients die from massive bleeding due to disseminated intravascular coagulation (DIC) with a fibrinolytic phenotype in the early phase, which transforms to DIC with a thrombotic phenotype in the late phase of trauma, contributing to the development of multiple organ dysfunction syndrome (MODS) and a consequently poor outcome. This is a sub-analysis of a multicenter prospective descriptive cross-sectional study on DIC to evaluate the effect of a DIC diagnosis on the survival probability and predictive performance of DIC scores for massive transfusion, MODS, and hospital death in severely injured trauma patients. A DIC diagnosis on admission was associated with a lower survival probability (Log Rank P < 0.001), higher frequency of massive transfusion and MODS and a higher mortality rate than no such diagnosis. The DIC scores at 0 and 3 h significantly predicted massive transfusion, MODS, and hospital death. Markers of thrombin and plasmin generation and fibrinolysis inhibition also showed a good predictive ability for these three items. In conclusion, a DIC diagnosis on admission was associated with a low survival probability. DIC scores obtained immediately after trauma predicted a poor prognosis of severely injured trauma patients.

Sign in / Sign up

Export Citation Format

Share Document