Demetriades et al identified factors associated with the need for major blood transfusion in a patient with a pelvic fracture. These can help to identify a patient who may have greater blood needs. The authors are from the University of Southern California in Los Angeles.
Patient selection: trauma patient with pelvic fracture
Outcome: major blood transfusion, defined as > 2,000 mL blood
Parameters (with significant p values):
(1) Injury Severity Score (ISS)
(2) pelvis AIS
(3) age in years
(4) therapeutic angiogram
Parameter |
Finding |
OR |
ISS |
<= 15 |
1 |
|
16 to 25 |
2.9 |
|
>= 26 |
5.2 |
pelvis AIS |
2 |
1 |
|
3 |
1.7 |
|
4 |
2.2 (*) |
|
5 |
4.7 |
age of the patient |
<= 55 years of age |
1 |
|
> 55 years of age |
1.9 |
therapeutic angiogram |
no |
1 |
|
yes |
3.2 |
where:
• The odds ratio for a pelvic AIS 4 is 1.1 in Table 7, which is less than the odds ratio for ASI 3. The OR for AIS <= 3 vs >= 4 is 2.2, which is used here.
• A therapeutic angiogram is more likely to be done in someone thought to have significant bleeding.
cumulative odds ratio for major blood transfusion =
= PRODUCT(odds ratios for each parameter)
Interpretation:
• minimum cumulative OR: 1
• maximum cumulative OR: 149
Specialty: Clinical Laboratory, Surgery, general, Anesthesiology, Emergency Medicine, Critical Care