Shock index in patients with traumatic solid organ injury as a predictor of massive blood transfusion protocol activation
<h3>Purpose</h3><p dir="ltr">We aimed to assess the utility of shock index (SI) to predict the need for massive transfusion protocol (MTP) in patients with solid organ injury (SOI) in a Level 1 Trauma center.</p><h3>Methods</h3><p dir="ltr"&...
محفوظ في:
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| مؤلفون آخرون: | , , , , |
| منشور في: |
2019
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| الموضوعات: | |
| الوسوم: |
إضافة وسم
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| الملخص: | <h3>Purpose</h3><p dir="ltr">We aimed to assess the utility of shock index (SI) to predict the need for massive transfusion protocol (MTP) in patients with solid organ injury (SOI) in a Level 1 Trauma center.</p><h3>Methods</h3><p dir="ltr">We conducted a retrospective analysis for patients with SOI between 2011 and 2014. Patients were categorized according to on-admission SI into low (< 0.8) and high SI (≥0.8) group.</p><h3>Results</h3><p dir="ltr">A total of 4500 patients were admitted with trauma, of them 572 sustained SOIs (289 patients had SI ≥0.8). In comparison to low SI, patients with high SI were younger, had higher injury severity scores (ISS) and lower Trauma and Injury Severity Score (TRISS); (<i>p</i>< 0.001). The proportion of exploratory laparotomy (EXLap), blood transfusion (BT), MTP activation, sepsis and hospital mortality were significantly higher in patients with high SI. Serum lactate (<i>r</i>= 0.34), hematocrit (<i>r</i>= − 0.34), ABC score (<i>r</i>= 0.62), ISS (<i>r</i>= 0.35), and amount of transfused blood (<i>r</i>= 0.22) were significantly correlated with SI. On multivariable regression analysis using 9 relevant variables (age, sex, ISS, ED GCS, serum lactate, hematocrit, Abdomen AIS and Focused assessment with sonography in trauma (FAST) and SI), SI ≥ 0.8 was an independent predictor of BT (OR 2.80; 95%CI 1.56–4.95) and MTP (OR 2.81;95% CI 1.09–7.21) .</p><h3>Conclusions</h3><p dir="ltr">In patients with SOI, SI is a simple bedside predictor for BT and MTP activation. Further prospective studies are needed to support our findings.</p><h2>Other Information</h2><p dir="ltr">Published in: Injury Epidemiology<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="http://dx.doi.org/10.1186/s40621-019-0218-7" target="_blank">http://dx.doi.org/10.1186/s40621-019-0218-7</a></p> |
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