Abstract 359: Clinical Decision Rule to Activate the Massive Transfusion Protocol for Severe Trauma Patients
Background: There is no clear activation criteria of the Massive Transfusion (MT) Protocol for severe trauma patients.
Objective: To create the Clinical Decision Rule (CDR) of MT Protocol activation, using Traumatic Bleeding Severity Score (TBSS).
Method: Single center retrospective study was performed. Severe trauma patients (Injury Severity Score >/= 16), who admitted to our center between 2010 and 2012 were enrolled. Initial TBSS and MT rate in each score of TBSS was calculated, and the area under the receiver operating characteristic curve (AUC) for MT were calculated. Those patients who were simple traumatic head injury or cardiopulmonary arrest on arrive were excluded.
Result: There were 264 patients in this study. AUC for MT was 0.947. When TBSS was 12 pts or less, MT rate was 3.7% (3/162). When TBSS was from 13 pts to 16pts, MT rate was 36.7% (11/30). When TBSS was 17 pts or more, MT rate was 94.4% (68/72). When TBSS was 19 pts or more, all patients received MT.
Discussion: It was reported that TBSS was superior to TASH Score or ABC Score (AHA ReSS 2012, ECTES 2103). According to the result of this study, the Low Risk Group for MT was patients whose TBSS was 12 pts or less, the Moderate Risk for MT was patients whose TBSS was from 13 pts to 16pts, and the High Risk Group for MT was patients whose TBSS was 17 pts or more. In reference to these risk classification, we propose the following CDR to activate the MT Protocol.
1: Activate the MT Protocol in the High Risk Group 2. DO NOT activate the MT Protocol in the Low Risk Group 3. In the Moderate Risk, repeatedly assess the TBSS and prepare for MT enough
Conclusion: We propose the CDR to activate the MT Protocol that we should carry out MT for the trauma patients whose TBSS is 17 pts or more.<!--EndFragment-->
- © 2013 by American Heart Association, Inc.