Prediction of pre-hospital blood transfusion in trauma patients based on scoring systems

BMC Emergency Medicine

Research

Anatolij Truhlář¹  Radomír Hyšpler²  Jana Berková³  Jaromír Kočí³  Jiří Páral⁴  Michal Plodr⁵ 

[1] Department of Anestesiology and Intensive Care Medicine, Charles University in Prague, University Hospital Hradec Kralove, 50003, Hradec Kralove, Czech Republic;Emergency Medical Services of the Hradec Kralove Region, 50012, Hradec Kralove, Czech Republic;Department of Clinical Chemistry, Charles University in Prague, University Hospital Hradec Kralove, 50003, Hradec Kralove, Czech Republic;Department of Emergency Medicine, Charles University in Prague, University Hospital Hradec Kralove, 50003, Hradec Kralove, Czech Republic;Emergency Medical Services of the Hradec Kralove Region, 50012, Hradec Kralove, Czech Republic;Department of Surgery, Charles University in Prague, University Hospital Hradec Kralove, 50003, Hradec Kralove, Czech Republic;Faculty of Military Health Sciences, University of Defence, 50001, Hradec Kralove, Czech Republic;Emergency Medical Services of the Hradec Kralove Region, 50012, Hradec Kralove, Czech Republic;

关键词: Pre-hospital;    Transfusion;    Trauma;    Shock index;    Pulse pressure;    Scoring systems;   

DOI  :  10.1186/s12873-022-00770-x

 received in 2022-07-27, accepted in 2022-12-27,  发布年份 2022

来源: Springer

【 摘 要 】

BackgroundPre-hospital blood transfusion (PHBT) is a safe and gradually expanding procedure applied to trauma patients. A proper decision to activate PHBT with the presently limited diagnostic options at the site of an incident poses a challenge for pre-hospital crews. The purpose of this study was to compare the selected scoring systems and to determine whether they can be used as valid tools in identifying patients with PHBT requirements.MethodsA retrospective single-center study was conducted between June 2018 and December 2020. Overall, 385 patients (aged [median; IQR]: 44; 24–60; 73% males) were included in this study. The values of five selected scoring systems were calculated in all patients. To determine the accuracy of each score for the prediction of PHBT, the Receiver Operating Characteristic (ROC) analysis was used and to measure the association, the odds ratio with 95% confidence intervals was counted (Fig. 1).ResultsRegarding the proper indication of PHBT, shock index (SI) and pulse pressure (PP) revealed the highest value of AUC and sensitivity/specificity ratio (SI: AUC 0.88; 95% CI 0.82–0.93; PP: AUC 0.85 with 95% CI 0.79–0.91).ConclusionShock index and pulse pressure are suitable tools for predicting PHBT in trauma patients.

【 授权许可】

CC BY   
© The Author(s) 2023

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