PMID- 20622617
OWN - NLM
STAT- MEDLINE
DCOM- 20100928
LR  - 20220330
IS  - 1529-8809 (Electronic)
IS  - 0022-5282 (Linking)
VI  - 69 Suppl 1
DP  - 2010 Jul
TI  - Multicenter validation of a simplified score to predict massive transfusion in 
      trauma.
PG  - S33-9
LID - 10.1097/TA.0b013e3181e42411 [doi]
AB  - BACKGROUND: Several studies have described predictive models to identify trauma 
      patients who require massive transfusion (MT). Early identification of lethal 
      exsanguination may improve survival in this patient population. The purpose of 
      the current study was to validate a simplified score to predict MT at multiple 
      Level I trauma centers. METHODS: All adult trauma patients treated at three Level 
      I trauma centers from July 2006 to June 2007 who (1) were transported directly 
      from the scene, (2) were trauma activations, and (3) received any blood 
      transfusions during admission were included. Assessment of Blood Consumption 
      (ABC) score developed using the same inclusion criteria for patients admitted to 
      a single trauma center (Vanderbilt University Medical Center [VUMC]-1) between 
      July 2005 and June 2006. ABC score calculated by assigning a value (0 or 1) to 
      each of the four parameters: penetrating mechanism, positive focused assessment 
      with sonography for trauma for fluid, arrival blood pressure <90 mm Hg, and 
      arrival pulse >120 bpm. A score of 2 was used as "positive" to predict MT. Area 
      under receiver-operating characteristic curve was calculated to compare the 
      predictive ability of the score at each institution. RESULTS: There were 586 
      patients in the developmental (VUMC-1), 513 patients at trauma center 1 (VUMC-2), 
      372 at trauma center 2 (PMH), and 133 at trauma center 3 (Johns Hopkins 
      Hospital). MT rate was similar between centers: 14% to 15%. Sensitivity and 
      specificity for the ABC score predicting MT ranged from 75% to 90% and 67% to 
      88%, respectively. Correctly classified patients and area under 
      receiver-operating characteristic curve, however, were 84% to 87% and 0.83 to 
      0.90, respectively. CONCLUSIONS: The ABC score is a valid instrument to predict 
      MT early in the patient's care and across various demographically diverse trauma 
      centers. Future research should focus on this score's ability to prospectively 
      identify patients who will receive MT.
FAU - Cotton, Bryan A
AU  - Cotton BA
AD  - Department of Surgery and the Center for Translational Injury Research, The 
      University of Texas Health Science Center, Houston, Texas 77030, USA. 
      bryan.a.cotton@uth.tmc.edu
FAU - Dossett, Lesly A
AU  - Dossett LA
FAU - Haut, Elliott R
AU  - Haut ER
FAU - Shafi, Shahid
AU  - Shafi S
FAU - Nunez, Timothy C
AU  - Nunez TC
FAU - Au, Brigham K
AU  - Au BK
FAU - Zaydfudim, Victor
AU  - Zaydfudim V
FAU - Johnston, Marla
AU  - Johnston M
FAU - Arbogast, Patrick
AU  - Arbogast P
FAU - Young, Pampee P
AU  - Young PP
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Validation Study
PL  - United States
TA  - J Trauma
JT  - The Journal of trauma
JID - 0376373
SB  - IM
MH  - Adult
MH  - Blood Transfusion/*statistics & numerical data
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Predictive Value of Tests
MH  - ROC Curve
MH  - Retrospective Studies
MH  - Risk Assessment
MH  - *Trauma Centers
MH  - *Trauma Severity Indices
MH  - Triage/*organization & administration
MH  - Wounds and Injuries/*classification/diagnosis/therapy
MH  - Young Adult
EDAT- 2010/08/05 06:00
MHDA- 2010/09/30 06:00
CRDT- 2010/07/13 06:00
PHST- 2010/07/13 06:00 [entrez]
PHST- 2010/08/05 06:00 [pubmed]
PHST- 2010/09/30 06:00 [medline]
AID - 00005373-201007001-00006 [pii]
AID - 10.1097/TA.0b013e3181e42411 [doi]
PST - ppublish
SO  - J Trauma. 2010 Jul;69 Suppl 1:S33-9. doi: 10.1097/TA.0b013e3181e42411.