Open AccessThe FASILA Score: A Novel Bio‐Clinical Score to Predict Massive Blood Transfusion in Patients with Abdominal Trauma
Author(s) -
ElMenyar Ayman,
Abdelrahman Husham,
AlThani Hassan,
Mekkodathil Ahammed,
Singh Rajvir,
Rizoli Sandro
Publication year - 2020
Publication title -
world journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.115
H-Index - 148
eISSN - 1432-2323
pISSN - 0364-2313
DOI - 10.1007/s00268-019-05289-0
Subject(s) - medicine , injury severity score , glasgow coma scale , revised trauma score , trauma center , blood transfusion , abdominal surgery , receiver operating characteristic , exploratory laparotomy , laparotomy , damage control surgery , abdominal trauma , surgery , retrospective cohort study , emergency medicine , resuscitation , poison control , injury prevention , blunt
Background Early identification of patients who may need massive blood transfusion remains a major challenge in trauma care. This study proposed a novel and easy‐to‐calculate prediction score using clinical and point of care laboratory findings in patients with abdominal trauma (AT). Methods Patients with AT admitted to a trauma center in Qatar between 2014 and 2017 were retrospectively analyzed. The FASILA score was proposed and calculated using focused assessment with sonography in trauma (0 = negative, 1 = positive), Shock Index (SI) (0 = 0.50–0.69, 1 = 0.70–0.79, 2 = 0.80–0.89, and 3 ≥ 0.90), and initial serum lactate (0 ≤ 2.0, 1 = 2.0–4.0, and 2 ≥ 4.0 mmol/l). Outcome variables included mortality, laparotomy, and massive blood transfusion (MT). FASILA was compared to other prediction scores using receiver operating characteristics and areas under the curves. Bootstrap procedure was employed for internal validation. Results In 1199 patients with a mean age of 31 ± 13.5 years, MT, MT protocol (MTP) activation, exploratory laparotomy (ExLap), and hospital mortality were related linearly with the FASILA score, Injury Severity Score, and total length of hospital stay. Initial hemoglobin, Revised Trauma Score (RTS), and Trauma Injury Severity Score (TRISS) were inversely proportional. FASILA scores correlated significantly with the Assessment of Blood Consumption (ABC) ( r = 0.65), Revised Assessment of Bleeding and Transfusion (RABT) ( r = 0.63), SI ( r = 0.72), RTS ( r = − 0.34), and Glasgow Coma Scale ( r = − 0.32) and outperformed other predictive systems (RABT, ABC, and SI) in predicting MT, MTP, ExLap, and mortality. Conclusions The novel FASILA score performs well in patients with abdominal trauma and offers advantages over other scores.