Traumatic Bleeding Severity Score (TBSS) of Ogura et al for Identifying a Trauma Patient Who May Require a Massive Blood Transfusion

Description

Ogura et al developed the Traumatic Bleeding Severity Score (TBSS) to evaluate a patient with severe trauma. This can be help to identify a patient who may require a massive blood transfusion. The authors are from Japan Red Cross Maebashi Hospital, Jichi Medical University and Tohoku University in Japan.

Patient selection: severe trauma

Parameters:

(1) age of the patient in years

(2) systolic blood pressure in mm Hg, following rapid infusion of 1,000 mL of crystalloid

(3) FAST (Focused Assessment with Sonography for Trauma) assessment of 6 sites

(4) pelvic fracture classified by AO type

(5) lactate concentration in mmol/L

Parameter	Findings	Points
age of the patient	<= 59 years of age	0
	>= 60 years of age	6
systolic blood pressure	>= 110 mm Hg	0
	100 to 109.9 mm Hg	4
	90 to 99.9 mm Hg	8
	< 90 mm Hg	12
pelvic fracture	none	0
	Type A	3
	Type B	6
	Type C	9
lactate concentration	< 2.5 mmol/L	0
	2.5 to 4.99 mmol/L	4
	5.0 to 7.49 mmol/L	8
	>= 7.5 mmol/L	12

Sites evaluated by FAST:

(1) pericardium

(2) right thorax

(3) left thorax

(4) perihepatic

(5) perisplenic

(6) pelvic

points for FAST exam =

= (number of abnormal scans) * 3

total score =

= SUM(points for all 5 parameters)

Interpretation:

• minimum score: 0

• maximum score: 57

• The higher the score, the greater the likelihood of requiring a massive blood transfusion.

Total Score	Risk Group	Percent Massive Transfusion
<= 10	low	3.4%
11 to 16	moderate	26%
>= 17	high	94%

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Traumatic Bleeding Severity Score (TBSS) of Ogura et al for Identifying a Trauma Patient Who May Require a Massive Blood Transfusion

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