Moore et al reported logistic regression models for predicting massive transfusion for a trauma patient. One model predicts the need for massive transfusion based on data collected during the first 30 minutes after arrival at the trauma center. The authors are from The Methodist Hospital (Houston), University of Colorado, University of Toronto, University of Southern California, University of Pittsburgh, University of Minnesota, University of Texas Health Science Center San Antonio and Technomics Research.
Patient selection: trauma
Criteria for massive transfusion: 3,000 mL of PRBCs in the first 24 hours (approximately 10 units). The authors later recommended that the definition be changed from first 24 hours to first 6 hours.
Parameters:
(1) ISS
(2) treatment at a referring hospital
(3) minimum systolic blood pressure (SBP) in first 30 minutes
(4) maximum INR in first 30 minutes
Parameter
Finding
Points
ISS
<= 25
0
> 25
0.6832
treatment at referring hospital
yes
-1.3316
no
0
minimum SBP
-0.0296 * (SBP)
maximum INR
1.2685 * (INR)
value of X =
= SUM(points for all of the parameters) - 0.1263
probability of massive transfusion =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is
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