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The emergency room transfusion score (ETS): prediction of blood transfusion requirement in initial resuscitation after severe trauma
Author(s) -
Ruchholtz S.,
Pehle B.,
Lewan U.,
Lefering R.,
Müller N.,
Oberbeck R.,
Waydhas C.
Publication year - 2006
Publication title -
transfusion medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.471
H-Index - 59
eISSN - 1365-3148
pISSN - 0958-7578
DOI - 10.1111/j.1365-3148.2006.00647.x
Subject(s) - medicine , logistic regression , blood transfusion , injury severity score , cutoff , revised trauma score , resuscitation , pelvic fracture , emergency medicine , surgery , poison control , injury prevention , physics , quantum mechanics , pelvis
summary . The presented study was initiated to develop a scoring system for the prediction of red blood cell transfusion requirement in the early care of trauma patients. All trauma patients admitted to our institution who needed trauma team activation were evaluated during a 4‐year period. A set of nine parameters with possible predictive value for the need of blood transfusion was recorded. All relevant data can be acquired during the first 10 min in the emergency room (ER). The data underwent multivariate logistic regression analysis for correlation and the calculation of predictive power. To transform the model into a practical score, we rounded all coefficients. The predictive power of the score was evaluated based on a linear regression equation. Of the 1103 patients (Injury Severity Score [ISS] 21 ± 16) included in the study, 116 (10·5%; ISS 39 ± 18) received blood in the ER. Early transfusion need was significantly correlated with systolic blood pressure (SBP) <90 mmHg (coefficient 2·5), SBP 90–120 mmHg (1·5), free fluid in abdominal ultrasound (2·0), clinically unstable pelvic ring fracture (1·5), age 20–60 years (0·5), age >60 years (1·5), admission from scene (1·0), traffic accident (1·0) and fall from >3 m (1·0). The probability for transfusion exponentially increased with the sum of points in the ER transfusion score, i.e. from 0·7% at one point to 5% at three points and 97% at 9·5 points maximum. To establish a practical cutoff point (risk <5%) a low‐risk group was defined at