Early identification of trauma patients in need for emergent transfusion: results of a single-center retrospective study evaluating three scoring systems
| Autor: | Jean Marc Minon, Alexandre Ghuysen, Martin Tonglet, Vincenzo D Orio, Frédéric Swerts, Pierre Yves Mathonet |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Scoring system Sports medicine Adolescent Blood Component Transfusion Hemorrhage Critical Care and Intensive Care Medicine Single Center Risk Assessment 03 medical and health sciences Hemoglobins Young Adult 0302 clinical medicine Injury Severity Score Belgium Coagulopathy medicine Humans Orthopedics and Sports Medicine Emergency Treatment Aged Retrospective Studies Aged 80 and over 030222 orthopedics business.industry 030208 emergency & critical care medicine Retrospective cohort study Middle Aged medicine.disease Identification (information) Early Diagnosis Emergency medicine Emergency Medicine Wounds and Injuries Surgery Base excess Female Level iii business |
| Zdroj: | European journal of trauma and emergency surgery : official publication of the European Trauma Society. 45(4) |
| ISSN: | 1863-9941 |
| Popis: | The Trauma-Induced Coagulopathy Clinical Score (TICCS) was developed to be calculable on the site of injury to discriminate between trauma patients with or without the need for damage control resuscitation and thus transfusion. This early alert could then be translated to in-hospital parameters at patient arrival. Base excess (BE) and ultrasound (FAST) are known to be predictive parameters for emergent transfusion. We emphasize that adding these two parameters to the TICCS could improve the scoring system predictability.A retrospective study was conducted in the University Hospital of Liège. TICCS was calculated for every patient. BE and FAST results were recorded and points were added to the TICCS according to the TICCS.BE definition (+ 3 points if BE - 5 and + 3 points in case of a positive FAST). Emergent transfusion was defined as the use of at least one blood product in the resuscitation room. The capacity of the TICCS, the TICCS.BE and the Trauma-Associated Severe Hemorrhage (TASH) to predict emergent transfusion was assessed.A total of 328 patients were included. Among them, 14% needed emergent transfusion. The probability for emergent transfusion grows with the TICCS and the TICCS.BE values. We did not find a significant difference between the TICCS (AUC 0.73) and the TICCS.BE (AUC 0.76). The TASH proved to be more predictive (AUC 0.89). 66.6% of the patients with a TICCS ≥ 10 and 81.5% with a TICCS.BE ≥ 14 required emergent transfusion.Adding BE and FAST to the original TICCS does not significantly improve the scoring system predictability. A prehospital TICCS 10 could be used as a trigger for emergent transfusion activation. TASH could then be used at hospital arrival. Prehospital TASH calculation may be possible but should be further investigated.Diagnostic test, level III. |
| Databáze: | OpenAIRE |
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