Yucek et al developed the Trauma Associated Severe Hemorrhage (TASH) score for identifying trauma patients who are likely to require massive blood transfusions. This is a surrogate marker for life-threatening hemorrhage after multiple trauma. The authors are from the Polytrauma Study Group of the German Trauma Society.
Parameters:
(1) gender
(2) pelvic fracture
(3) femur fracture
(4) free intra-abdominal fluid on FAST examination
(5) heart rate in beats per minute
(6) systolic blood pressure in mm Hg
(7) hemoglobin in g/dL
(8) base excess in mmol/L
|
Parameter |
Finding |
Points |
|---|---|---|
|
gender |
female |
0 |
|
|
male |
1 |
|
pelvic fracture |
none |
0 |
|
|
clinically stable |
0 |
|
|
clinically unstable |
6 |
|
femur fracture |
none |
0 |
|
|
closed |
0 |
|
|
open and/or dislocated |
3 |
|
free intra-abdominal fluid |
absent |
0 |
|
|
present |
3 |
|
heart rate in beats per minute |
<= 120 beats per minute |
0 |
|
|
> 120 beats per minute |
2 |
|
systolic blood pressure |
< 100 mm Hg |
4 |
|
|
100 - 119 mm Hg |
1 |
|
|
>= 120 mm Hg |
0 |
|
hemoglobin |
< 7.00 g/dL |
8 |
|
|
7.00 to 8.99 |
6 |
|
|
9.00 to 9.99 |
4 |
|
|
10.00 to 10.99 |
3 |
|
|
11.00 to 11.99 |
2 |
|
|
>= 12 g/dL |
0 |
|
base excess |
< -10.00 mmol/L |
4 |
|
|
-6.01 to -10.00 mmol/L |
3 |
|
|
-2.01 to -6.00 mmol/L |
1 |
|
|
>= -2.00 mmol/L |
0 |
where:
• It appears that only the worse femoral fracture gets scored if there is more than 1.
total TASH score =
= SUM(points for all 8 parameters)
Interpretation:
• minimum score: 0
• maximum score: 28
• Cutoffs of >=10 or >= 16 can be used.
• The higher the score the greater the likelihood of requiring massive blood transfusion.
X =
= (0.3 * (TASH score)) - 4.9
probability of requiring massive transfusion =
= 1 / (1 + EXP((-1) * X))
Purpose: To determine if a patient with multiple traumatic injuries is likely to require massive blood transfusions based on the TASH score of Yucel et al.
Specialty: Clinical Laboratory, Surgery, general, Anesthesiology, Emergency Medicine, Critical Care
Objective: criteria for diagnosis, severity, prognosis, stage, selection
ICD-10: D62, T79, Z51.3,
