Prediction of pre-hospital blood transfusion in trauma patients based on scoring systems

Abstract

Background Pre-hospital blood transfusion (PHBT) is a safe and gradually expanding procedure applied in trauma patients. A proper decision to activate PHBT in presently limited diagnostic options at the site of incident poses a challenge for pre-hospital crews. The purpose of this study was to compare the selected scoring systems and to determine whether they can be used as a valid tool in identifying patients with PHBT requirement. Methods A retrospective single-center study was conducted between June 2018 and December 2020. Overall, 385 patients (aged [median; IQR]: 44; 24–60; 73% males) were included in this study. The values of six selected scoring systems were calculated in all patients. To determine accuracy of each score for the prediction of PHBT, the Receiver Operating Characteristic (ROC) analysis was used and to measure of association, the odds ratio with 95% confidence intervals was count. Results Regarding the proper indication of PHBT, shock index (SI), reversed shock index (rSI) and pulse pressure (PP) revealed the highest value of AUC and sensitivity/specificity ratio (SI: AUC 0,88; 95% CI 0,82 − 0,93; rSI: AUC 0,88; 95% CI 0,82 − 0,94; PP: AUC 0,85 with 95% CI 0,79 − 0,91). Conclusion Shock index, reversed shock index and pulse pressure are suitable tools for predicting PHBT in trauma patients.