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

• Published in: Scientific reports Vol. 14; no. 1; pp. 13395 - 11
• Main Authors: Barbosa Rengifo, Mario Miguel, Garcia, Alberto F., Gonzalez-Hada, Adolfo, Mejia, Nancy J.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 11-06-2024; Nature Publishing Group; Nature Portfolio
• Subjects: 692/1807; 692/308; 692/308/174; 692/308/409; 692/700; 692/700/139; 692/700/1750; 692/700/478; Adult; Bleeding; Blood; Blood transfusion; Blood Transfusion - methods; Cardiac tamponade; Decision making; Female; General surgery; Hemorrhage - diagnosis; Hemorrhage - etiology; Hemorrhage - therapy; Hemothorax; Humanities and Social Sciences; Humans; Injury Severity Score; Male; Middle Aged; multidisciplinary; Observational studies; Pneumothorax; Prediction models; Prognosis; Resource allocation; Retrospective Studies; Science; Science (multidisciplinary); Shock - diagnosis; Shock - etiology; Shock - therapy; Thoracic injuries; Thoracic Injuries - therapy; Thorax; Transfusion; Trauma; Wounds, Penetrating - therapy; Thoracic injuries; Pneumothorax; General surgery; Blood transfusion; Hemothorax; Cardiac tamponade
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-62579-x

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.