Prediction of Blood Transfusion in a Pediatric Blunt Trauma Patient Based on SIPA Values

Phillips et al evaluated pediatric patients with blunt trauma and correlated the SIPA (shock index, pediatric-adjusted) score with blood transfusion.

Patient selection: pediatric blunt trauma

shock index =

= (heart rate) / (systolic blood pressure)

With SIPA the shock index is compared against age-adjusted cut-offs.

Predictors of blood transfusion:

(1) elevated SIPA (OR 2.9)

(2) ISS (OR 1.1; will used >= 10 in the implementation)

(3) prehospital intubation (OR 4.6)

(4) positive FAST (OR 2.4)

Age	Prehospital SIPA Cutoff for Transfusion
1 to 6 years	>= 1.52
7 to 12 years	>= 1.17
>= 13 years	>= 0.99

Age	Emergency Dept SIPA Cutoff for Transfusion
1 to 6 years	>= 1.27
7 to 12 years	>= 1.20
>= 13 years	>= 0.86

Clinical outcomes (mortality, duration in ICU, nosocomial infection, etc) were increased in patients who received transfusion vs those who did not.

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