Comparison of predictive blood transfusion scoring systems in trauma patients and application to pre-hospital medicine

2021 ◽  
pp. 1-4
Author(s):  
Stuart Weston ◽  
Cory Ziegler ◽  
Marianne Meyers ◽  
Ariane Kubena ◽  
Kendall Hammonds ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Hospital Medicine ◽  
Scoring Systems ◽  
Trauma Patients

scholarly journals Review of Existing Scoring Systems for Massive Blood Transfusion in Trauma Patients

Shock ◽  
2019 ◽  
Vol 52 (3) ◽  
pp. 288-299 ◽  
Author(s):  
Ayman El-Menyar ◽  
Ahammed Mekkodathil ◽  
Husham Abdelrahman ◽  
Rifat Latifi ◽  
Sagar Galwankar ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Scoring Systems ◽  
Trauma Patients ◽  
Massive Blood Transfusion

scholarly journals Massive Blood Transfusion for Trauma Score to Predict Massive Blood Transfusion in Trauma

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Osaree Akaraborworn ◽  
Boonying Siribumrungwong ◽  
Burapat Sangthong ◽  
Komet Thongkhao
Keyword(s):  
Blood Transfusion ◽  
Goodness Of Fit ◽  
Prehospital Care ◽  
Multivariable Analysis ◽  
Positive Likelihood Ratio ◽  
Scoring Systems ◽  
Trauma Team ◽  
Trauma Patients ◽  
Internal Validation ◽  
Massive Blood Transfusion

Background. Massive blood loss is the most common cause of immediate death in trauma. A massive blood transfusion (MBT) score is a prediction tool to activate blood banks to prepare blood products. The previously published scoring systems were mostly developed from settings that had mature prehospital systems which may lead to a failure to validate in settings with immature prehospital systems. This research aimed to develop a massive blood transfusion for trauma (MBTT) score that is able to predict MBT in settings that have immature prehospital care. Methods. This study was a retrospective cohort that collected data from trauma patients who met the trauma team activation criteria. The predicting parameters included in the analysis were retrieved from the history, physical examination, and initial laboratory results. The significant parameters from a multivariable analysis were used to develop a clinical scoring system. The discrimination was evaluated by the area under a receiver operating characteristic (AuROC) curve. The calibration was demonstrated with Hosmer–Lemeshow goodness of fit, and an internal validation was done. Results. Among 867 patients, 102 (11.8%) patients received MBT. Four factors were associated with MBT: a score of 3 for age ≥60 years; 2.5 for base excess ≤–10 mEq/L; 2 for lactate >4 mmol/L; and 1 for heart rate ≥105 /min. The AuROC was 0.85 (95% CI: 0.78–0.91). At the cut point of ≥4, the positive likelihood ratio of the score was 6.72 (95% CI: 4.7–9.6, p  < 0.001), the sensitivity was 63.6%, and the specificity was 90.5%. Internal validation with bootstrap replications had an AuROC of 0.83 (95% CI: 0.75–0.91). Conclusions. The MBTT score has good discrimination to predict MBT with simple and rapidly obtainable parameters.

scholarly journals Anemia and blood transfusion in elderly trauma patients

2018 ◽  
Vol 229 ◽  
pp. 288-293 ◽  
Author(s):  
Tyler J. Loftus ◽  
Scott C. Brakenridge ◽  
Travis W. Murphy ◽  
Linda L. Nguyen ◽  
Frederick A. Moore ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Trauma Patients ◽  
Elderly Trauma Patients

Prehospital Blood Product Administration Opportunities in Ground Transport ALS EMS – A Descriptive Study

2018 ◽  
Vol 33 (3) ◽  
pp. 230-236 ◽  
Author(s):  
Felicia M. Mix ◽  
Martin D. Zielinski ◽  
Lucas A. Myers ◽  
Kathy S. Berns ◽  
Anurahda Luke ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Patient Care ◽  
Blood Product ◽  
Life Support ◽  
Descriptive Study ◽  
Blood Product Transfusion ◽  
Trauma Patients ◽  
Blood Products ◽  
Total Patient ◽  
Significant Difference

AbstractIntroductionHemorrhage remains the major cause of preventable death after trauma. Recent data suggest that earlier blood product administration may improve outcomes. The purpose of this study was to determine whether opportunities exist for blood product transfusion by ground Emergency Medical Services (EMS).MethodsThis was a single EMS agency retrospective study of ground and helicopter responses from January 1, 2011 through December 31, 2015 for adult trauma patients transported from the scene of injury who met predetermined hemodynamic (HD) parameters for potential transfusion (heart rate [HR]≥120 and/or systolic blood pressure [SBP]≤90).ResultsA total of 7,900 scene trauma ground transports occurred during the study period. Of 420 patients meeting HD criteria for transfusion, 53 (12.6%) had a significant mechanism of injury (MOI). Outcome data were available for 51 patients; 17 received blood products during their emergency department (ED) resuscitation. The percentage of patients receiving blood products based upon HD criteria ranged from 1.0% (HR) to 5.9% (SBP) to 38.1% (HR+SBP). In all, 74 Helicopter EMS (HEMS) transports met HD criteria for blood transfusion, of which, 28 patients received prehospital blood transfusion. Statistically significant total patient care time differences were noted for both the HR and the SBP cohorts, with HEMS having longer time intervals; no statistically significant difference in mean total patient care time was noted in the HR+SBP cohort.ConclusionsIn this study population, HD parameters alone did not predict need for ED blood product administration. Despite longer transport times, only one-third of HEMS patients meeting HD criteria for blood administration received prehospital transfusion. While one-third of ground Advanced Life Support (ALS) transport patients manifesting HD compromise received blood products in the ED, this represented 0.2% of total trauma transports over the study period. Given complex logistical issues involved in prehospital blood product administration, opportunities for ground administration appear limited within the described system.MixFM, ZielinskiMD, MyersLA, BernsKS, LukeA, StubbsJR, ZietlowSP, JenkinsDH, SztajnkrycerMD. Prehospital blood product administration opportunities in ground transport ALS EMS – a descriptive study. Prehosp Disaster Med. 2018;33(3):230–236.

Blood Transfusion is an Independent Predictor of Mortality after Blunt Trauma

2007 ◽  
Vol 73 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Anthony Charles ◽  
Almaasa Shaikh ◽  
Madonna Walters ◽  
Susan Huehl ◽  
Richard Pomerantz
Keyword(s):  
Logistic Regression ◽  
Blood Transfusion ◽  
Blunt Trauma ◽  
Injury Severity ◽  
Trauma Registry ◽  
Blunt Injury ◽  
Trauma Patients ◽  
Trauma Population ◽  
Transfusion Requirements ◽  
Level 2

Allogeneic blood transfusion is associated with increased morbidity and mortality. The authors evaluated the affect of blood transfusion, independent of injury severity on mortality. The authors conducted a retrospective review of all patients, age ≥18 years with blunt injury admitted to their Level 2 trauma center from 1994 to 2004 by query of the NTRACS trauma registry. Initial systolic blood pressure and heart rate determined the shock index. Logistic regression was used to model the affect of blood transfusion on mortality. Transfusion requirements were categorized as follows: A, 0 U; B, 1 to 2 U; C, 3 to 5 U; D, ≥6 U blood. In this sample of 8215 blunt trauma patients, 324 patients received blood transfusion. Mortality rates between the transfused and nontransfused groups were 15.12 per cent and 1.84 per cent ( P < 0.000) respectively. In the logistic regression model, transfusion category B did not have a significant affect on the odds of death ( P = 0.176); the affect of transfusing 3 to 5 U and ≥6 U had a mortality odds ratio of 3.22 ( P = 0.002) and 4.87 ( P = 0.000) respectively. Transfusing ≥2U blood was strongly associated with mortality in this blunt trauma population. There must be a continuous attempt to limit blood transfusion when feasible and physiologically appropriate.

Anemia and Blood Transfusion in Trauma Patients Admitted to the Intensive Care Unit

2003 ◽  
Vol 55 (2) ◽  
pp. 269-274 ◽  
Author(s):  
Marc J. Shapiro ◽  
Andrew Gettinger ◽  
Howard L. Corwin ◽  
Lena Napolitano ◽  
Mitchell Levy ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Transfusion ◽  
Trauma Patients

Blood Transfusion is Associated with Donor Leukocyte Microchimerism in Trauma Patients

2004 ◽  
Vol 57 (4) ◽  
pp. 702-708 ◽  
Author(s):  
Garth H. Utter ◽  
John T. Owings ◽  
Tzong-Hae Lee ◽  
Teresa G. Paglieroni ◽  
William F. Reed ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Trauma Patients

scholarly journals Utility Of Angioembolization In Patients with Abdominal and Pelvic Traumatic Bleeding: Descriptive Observational Analysis From A Level 1 Trauma Center

2020 ◽  
Author(s):  
Hassan Al-Thani ◽  
Husham Abdelrahman ◽  
Ali Barah ◽  
Mohammad Asim ◽  
Ayman El-Menyar
Keyword(s):  
Blood Transfusion ◽  
Success Rate ◽  
Trauma Center ◽  
Clinical Success Rate ◽  
Trauma Patients ◽  
Solid Organ ◽  
Complication Rates ◽  
Traumatic Bleeding ◽  
Level 1 ◽  
Level 1 Trauma Center

Abstract Background: Massive bleeding is a major preventable cause of early death in trauma. It often requires surgical or endovascular intervention. We aimed to describe the utilization of angioembolization in patients with abdominal and pelvic traumatic bleeding at a level 1 trauma center.Methods: We conducted a retrospective analysis for all trauma patients who underwent angioembolization post-traumatic bleeding between January 2012 and April 2018. Patients’s data and details of injuries, angiography procedures and outcomes were extracted from the Qatar national trauma registry.Results: A total of 175 trauma patients underwent angioembolization during the study period (103 for solid organ injury , 51 for pelvic injury and 21 for other injuries). The majority were young males. The main cause of injury was blunt trauma in 95.4% of patients. The most common indication of angioembolization was evident active bleeding on the initial CT scan (contrast pool or blushes). Blood transfusion was needed in two-third of patients. The hepatic injury cases had higher ISS, higher shock Index and more blood transfusion Absorbable particles (Gelfoam) was the most commonly used embolic material. The overall technical and clinical success rate was 93.7% and 95% respectively with low rebleeding and complication rates. The hospital and ICU length of stay were13 and 6 days respectively. The median injury to intervention time was 320 min while hospital arrival to intervention time was 274 min. The median follow-up time was 215 days. The overall cohort mortality was 15%. Conclusion: Angioembolization is an effective intervention to stop bleeding and support nonoperative management for both solid organ injuries and pelvic trauma. It has a high success rate with a careful selection and proper implementation.

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