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 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

Patterns of paediatric massive blood transfusion protocol use in trauma and non‐trauma patients

2021 ◽  
Author(s):  
Emily C. Alberto ◽  
Yinan Zheng ◽  
Zachary P. Milestone ◽  
Megan Cheng ◽  
Omar Z. Ahmed ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Trauma Patients ◽  
Massive Blood Transfusion ◽  
Transfusion Protocol

scholarly journals P043: Trauma team leaders in Canada: A national survey

CJEM ◽  
2019 ◽  
Vol 21 (S1) ◽  
pp. S78
Author(s):  
V. Belhumeur ◽  
C. Malo ◽  
A. Nadeau ◽  
S. Hegg ◽  
A. Gagné ◽  
...  
Keyword(s):  
Prehospital Care ◽  
Injured Patient ◽  
Trauma Team ◽  
Initial Assessment ◽  
Trauma Patients ◽  
Lack Of Information ◽  
Level 1 ◽  
Patient Prognosis ◽  
Activation Criteria ◽  
Early Trauma

Introduction: It was demonstrated that the early trauma team activation (TTA) could improve younger trauma patients outcomes and mortality rates. However, the link between older patient prognosis improvement and the activation / effectiveness of the Trauma team (TT) is still unclear. There is also a lack of information about the exact and optimal structure of TTs and their activation criteria, which may differ across centers. The main objective of this study is to provide a description of the current TT available in level 1 and 2 centres across Canada. Methods: In 2017, a survey using a modified Dillman technique was sent to 210 health professionals scattered across all Canadian trauma care facilities. The survey included questions regarding 1) the presence and the composition of a TT, 2) the established TT activation criteria, and finally 3) the initial patient care. Results: A total of 107 (57%) completed surveys were received. Among them, only 22 (11.7%) were from level 1 or 2 centres and were therefore considered for analyses. Seventeen respondents had a TT in their centre, and they all shared their TT activation criteria (1 to 27 different indications). Most frequently mentioned criteria were: suspected injuries (58.8%), judgment of the emergency physician (41.2%), systolic blood pressure (47.1%), Glasgow Coma score (35.3%) and respiratory rate (28%). In presence of a prehospital care warning trauma, the initial assessment of a severely injured patient is exclusively completed by a member of the TT for only 35.1% of the respondents. For 11.8% of respondents, TT coordinates airway management. For 64.7% of participants, the TT leader is the dedicated care provider to accompany patients until final orientation. Conclusion: These results suggest a great variability across Canada regarding the roles assumed by the TT, but also regarding the activation criteria leading them to take action.

Clinical suspicion regarding needle decompression for patients with chest trauma

2019 ◽  
Vol 11 (8) ◽  
pp. 330-334
Author(s):  
Alastair Beaven ◽  
James Harrison ◽  
Keith Porter ◽  
Richard Steyn
Keyword(s):  
Chest Trauma ◽  
Prehospital Care ◽  
Tension Pneumothorax ◽  
Trauma Team ◽  
Trauma Network ◽  
Trauma Patients ◽  
Care Providers ◽  
Trauma Population ◽  
The Uk ◽  
Needle Decompression

Background: Needle decompression of the chest is indicated for patients in a critical condition with rapid deterioration who have a life-threatening tension pneumothorax. Aim: To reassure UK prehospital care providers that needle decompression of the chest is not commonly required in chest trauma patients, and most can be safely managed without it. Methods: Case studies as part of a major trauma network continuous review process have revealed instances of needle decompression in the absence of tension pneumothorax. Images are presented where needle decompression was attempted in the absence of tension pneumothorax. Context: Expert opinion from our network's multidisciplinary trauma team discuss the occurrence of tension pneumothorax in self-ventilating patients, and the idea that tension pneumothorax is rare in the UK civilian trauma population is acknowledged. Other causes of chest hypoventilation are discussed.

scholarly journals Development and Internal Validation of a Nomogram to Predict Mortality During the ICU Stay of Thoracic Fracture Patients Without Neurological Compromise: An Analysis of the MIMIC-III Clinical Database

2021 ◽  
Vol 9 ◽  
Author(s):  
Haosheng Wang ◽  
Yangyang Ou ◽  
Tingting Fan ◽  
Jianwu Zhao ◽  
Mingyang Kang ◽  
...  
Keyword(s):  
Intensive Care ◽  
Calibration Curve ◽  
Clinical Benefit ◽  
Goodness Of Fit ◽  
Scoring Systems ◽  
Receiver Operating Curve ◽  
Internal Validation ◽  
Icu Stay ◽  
Net Clinical Benefit ◽  
Mimic Iii

Background: This study aimed to develop and validate a nomogram for predicting mortality in patients with thoracic fractures without neurological compromise and hospitalized in the intensive care unit.Methods: A total of 298 patients from the Medical Information Mart for Intensive Care III (MIMIC-III) database were included in the study, and 35 clinical indicators were collected within 24 h of patient admission. Risk factors were identified using the least absolute shrinkage and selection operator (LASSO) regression. A multivariate logistic regression model was established, and a nomogram was constructed. Internal validation was performed by the 1,000 bootstrap samples; a receiver operating curve (ROC) was plotted, and the area under the curve (AUC), sensitivity, and specificity were calculated. In addition, the calibration of our model was evaluated by the calibration curve and Hosmer-Lemeshow goodness-of-fit test (HL test). A decision curve analysis (DCA) was performed, and the nomogram was compared with scoring systems commonly used during clinical practice to assess the net clinical benefit.Results: Indicators included in the nomogram were age, OASIS score, SAPS II score, respiratory rate, partial thromboplastin time (PTT), cardiac arrhythmias, and fluid-electrolyte disorders. The results showed that our model yielded satisfied diagnostic performance with an AUC value of 0.902 and 0.883 using the training set and on internal validation. The calibration curve and the Hosmer-Lemeshow goodness-of-fit (HL). The HL tests exhibited satisfactory concordance between predicted and actual outcomes (P = 0.648). The DCA showed a superior net clinical benefit of our model over previously reported scoring systems.Conclusion: In summary, we explored the incidence of mortality during the ICU stay of thoracic fracture patients without neurological compromise and developed a prediction model that facilitates clinical decision making. However, external validation will be needed in the future.

MASSIVE BLOOD TRANSFUSION IN TRAUMA PATIENTS

1982 ◽  
Vol 22 (7) ◽  
pp. 630 ◽  
Author(s):  
Susan E. Miller ◽  
Robert C. Lim ◽  
Pearl T.C.Y. Toy
Keyword(s):  
Blood Transfusion ◽  
Trauma Patients ◽  
Massive Blood Transfusion

Predictive model integrating dynamic parameters for massive blood transfusion in major trauma patients: The Dynamic MBT score

2018 ◽  
Vol 36 (8) ◽  
pp. 1444-1450 ◽  
Author(s):  
Chun Tat Lui ◽  
Oi Fung Wong ◽  
Kwok Leung Tsui ◽  
Chak Wah Kam ◽  
Siu Man Li ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Predictive Model ◽  
Major Trauma ◽  
Trauma Patients ◽  
Dynamic Parameters ◽  
Massive Blood Transfusion
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