Comparison of Shock Index With the Assessment of Blood Consumption Score for Association With Massive Transfusion During Hemorrhage Control for Trauma
Copyright © 2021 Society of Trauma Nurses..
BACKGROUND: Hemorrhage is a leading cause of early mortality following trauma. A massive transfusion protocol (MTP) to guide resuscitation while bleeding is definitively controlled may improve outcomes. Prompts to initiate massive transfusion (MT) include shock index (SI) and the Assessment of Blood Consumption (ABC) score.
OBJECTIVE: To compare SI with the ABC score for association with transfusion requirement, need for emergency hemorrhage interventions, and early mortality.
METHODS: A retrospective cohort analysis of trauma MTP activations at our Level I trauma center was conducted from January 1, 2012, to December 31, 2016. The study data were obtained from the Trauma Registry and the blood bank. An SI cutoff of 1.0 was chosen for comparison with the positive ABC score.
RESULTS: The study cohort included 146 patients. Shock index ≥ 1 had significant association with MT requirement (p = .002) whereas a positive ABC score did not (p = .65). More patients with SI ≥ 1 required bleeding control interventions (67% surgery, 47% interventional radiology) than patients having a positive ABC score (49% surgery, 29% interventional radiology). For geriatric patients who received MT, 65% had SI ≥ 1 but only 30% had a positive ABC score. Three-hour mortality following emergency department arrival was similar (60% SI ≥ 1, 62% positive ABC score).
CONCLUSION: Shock index ≥ 1 outperformed a positive ABC score for association with MT requirement. Shock index is a simple tool registered nurses can independently utilize to anticipate MT.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:28 |
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| Enthalten in: |
Journal of trauma nursing : the official journal of the Society of Trauma Nurses - 28(2021), 6 vom: 12. Nov., Seite 341-349 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Day, Darcy L [VerfasserIn] |
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| Anmerkungen: |
Date Completed 16.11.2021 Date Revised 16.11.2021 published: Print Citation Status MEDLINE |
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| doi: |
10.1097/JTN.0000000000000613 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM333048024 |
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| 500 | |a Date Completed 16.11.2021 | ||
| 500 | |a Date Revised 16.11.2021 | ||
| 500 | |a published: Print | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2021 Society of Trauma Nurses. | ||
| 520 | |a BACKGROUND: Hemorrhage is a leading cause of early mortality following trauma. A massive transfusion protocol (MTP) to guide resuscitation while bleeding is definitively controlled may improve outcomes. Prompts to initiate massive transfusion (MT) include shock index (SI) and the Assessment of Blood Consumption (ABC) score | ||
| 520 | |a OBJECTIVE: To compare SI with the ABC score for association with transfusion requirement, need for emergency hemorrhage interventions, and early mortality | ||
| 520 | |a METHODS: A retrospective cohort analysis of trauma MTP activations at our Level I trauma center was conducted from January 1, 2012, to December 31, 2016. The study data were obtained from the Trauma Registry and the blood bank. An SI cutoff of 1.0 was chosen for comparison with the positive ABC score | ||
| 520 | |a RESULTS: The study cohort included 146 patients. Shock index ≥ 1 had significant association with MT requirement (p = .002) whereas a positive ABC score did not (p = .65). More patients with SI ≥ 1 required bleeding control interventions (67% surgery, 47% interventional radiology) than patients having a positive ABC score (49% surgery, 29% interventional radiology). For geriatric patients who received MT, 65% had SI ≥ 1 but only 30% had a positive ABC score. Three-hour mortality following emergency department arrival was similar (60% SI ≥ 1, 62% positive ABC score) | ||
| 520 | |a CONCLUSION: Shock index ≥ 1 outperformed a positive ABC score for association with MT requirement. Shock index is a simple tool registered nurses can independently utilize to anticipate MT | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Ng, Karen |e verfasserin |4 aut | |
| 700 | 1 | |a Huang, Jonathan B |e verfasserin |4 aut | |
| 700 | 1 | |a Severino, Richard |e verfasserin |4 aut | |
| 700 | 1 | |a Hayashi, Michael S |e verfasserin |4 aut | |
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