Cornero et al reported a model for predicting massive transfusion in a trauma patient. This can help to identify a patient who may require a large volume of blood products. The authors are from University of Milano, University of Witten/Herdecke and the University of Maryland.
Massive transfusion: receipt of >= 4 units of blood during the first 24 hours
Parameters:
(1) minimum prehospital Glasgow coma scale value
(2) prehospital administration of tranexamic acid
(3) penetrating trauma
(4) hemothorax
(5) pelvic fracture
(6) E-FAST exam
(7) heart rate in the ED in beats per minute
(8) systolic blood pressure in the ED
(9) PTT in seconds
Parameter
Finding
Points
minimum prehospital GCS
3
1
4 to 15
0
tranexamic acid
no
0
yes
1
penetrating trauma
no
0
yes
1
hemothorax
no
0
yes
1
pelvic fracture
no
0
yes
1
E-FAST exam
negative
0
positive
1
heart rate
< 120 beats per minute
0
>= 120 beats per minute
1
systolic blood pressure
<= 70 mm Hg
1
> 70 mm Hg
0
PTT
< 40 seconds
0
>= 40 seconds
2
total score =
= SUM(points for all 9 parameters)
Interpretation:
• minimum score: 0
• maximum score: 10
• The higher the score the greater the risk of massive transfusion.
Score
Massive Transfusion
0
0%
1
8%
2
28%
3
53%
4
86%
5
91%
>= 6
100%
Performance:
• The area under the ROC curve is 0.85.
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