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Observational Study
. 2024 Jun 11;14(1):13395.
doi: 10.1038/s41598-024-62579-x.

Evaluating the Shock Index, Revised Assessment of Bleeding and Transfusion (RABT), Assessment of Blood Consumption (ABC) and novel PTTrauma score to predict critical transfusion threshold (CAT) in penetrating thoracic trauma

Mario Miguel Barbosa Rengifo  1   2   3 , Alberto F Garcia  4   5   6 , Adolfo Gonzalez-Hada  4 , Nancy J Mejia  4
Affiliations
Observational Study

Evaluating the Shock Index, Revised Assessment of Bleeding and Transfusion (RABT), Assessment of Blood Consumption (ABC) and novel PTTrauma score to predict critical transfusion threshold (CAT) in penetrating thoracic trauma

Mario Miguel Barbosa Rengifo et al. Sci Rep. .

Abstract

The shock index (SI) has been associated with predicting transfusion needs in trauma patients. However, its utility in penetrating thoracic trauma (PTTrauma) for predicting the Critical Administration Threshold (CAT) has not been well-studied. This study aimed to evaluate the prognostic value of SI in predicting CAT in PTTrauma patients and compare its performance with the Assessment of Blood Consumption (ABC) and Revised Assessment of Bleeding and Transfusion (RABT) scores. We conducted a prognostic type 2, single-center retrospective observational cohort study on patients with PTTrauma and an Injury Severity Score (ISS) > 9. The primary exposure was SI at admission, and the primary outcome was CAT. Logistic regression and decision curve analysis were used to assess the predictive performance of SI and the PTTrauma score, a novel model incorporating clinical variables. Of the 620 participants, 53 (8.5%) had more than one CAT. An SI > 0.9 was associated with CAT (adjusted OR 4.89, 95% CI 1.64-14.60). The PTTrauma score outperformed SI, ABC, and RABT scores in predicting CAT (AUC 0.867, 95% CI 0.826-0.908). SI is a valuable predictor of CAT in PTTrauma patients. The novel PTTrauma score demonstrates superior performance compared to existing scores, highlighting the importance of developing targeted predictive models for specific injury patterns. These findings can guide clinical decision-making and resource allocation in the management of PTTrauma.

Keywords: Blood transfusion; Cardiac tamponade; General surgery; Hemothorax; Pneumothorax; Thoracic injuries.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Patient inclusion flowchart: selection and exclusion criteria.
Figure 2
Figure 2
Operating characteristics of Shock Index and PTTrauma model for the prediction of CAT > 1 within 4 h from admission.
Figure 3
Figure 3
Decision curve analysis curves of each score: PTTrauma, shock index, ABC, and RABT.
See this image and copyright information in PMC

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