Ichiba Shingo    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Professor
Article types	Original article
Language	English
Peer review	Peer reviewed
Title	Immediate screening method for predicting the necessity of massive transfusions in trauma patients: a retrospective single-center study.
Journal	Formal name：Journal of intensive care Abbreviation：J Intensive Care ISSN code：20520492/20520492
Domestic / Foregin	Foregin
Volume, Issue, Page	2(1),pp.54
Author and coauthor	Yumoto Tetsuya, Iida Atsuyoshi, Hirayama Takahiro, Tsukahara Kohei, Shiba Naoki, Yamanouchi Hideo, Sato Keiji, Ugawa Toyomu, Ichiba Shingo, Ujike Yoshihito
Publication date	2014
Summary	BACKGROUND:Hemostatic resuscitation might improve the survival of severely injured trauma patients. Our objective was to establish a simplified screening system for determining the necessity of massive transfusions (MT) at an early stage in trauma cases.METHODS:We retrospectively analyzed the cases of trauma patients who had been transported to our institution between November 2011 and October 2013. Patients who were younger than 18 years of age or who were confirmed to have suffered a cardiac arrest at the scene or on arrival were excluded. MT were defined as transfusions involving the delivery of ≥10 units of red blood cell concentrate within the first 24 h after arrival.RESULTS:A total of 259 trauma patients were included in this study (males: 178, 69%). Their mean age was 49 ± 20, and their median injury severity score was 14.4. Thirty-three (13%) of the patients required MT. The presence of a shock index of ≥1, a base excess of ≤ -3 mmol/L, or a positive focused assessment of sonography for trauma (FAST) result was found to exhibit sensitivity and specificity values of 0.97 and 0.81, respectively, for predicting the necessity of MT. Furthermore, this method displayed an area under the receiver operating characteristic curve of 0.934 (95% confidence interval, 0.891-0.978), which indicated that it was highly accurate.CONCLUSIONS:Our screening method based on the shock index, base excess, and FAST result is a simple and useful way of predicting the necessity of MT early after trauma.
DOI	10.1186/s40560-014-0054-3
PMID	25705412