Comparative study between shock index and assessment of blood consumption score in polytrauma patients as a predictor of massive blood transfusion

Abstract

Background Hemorrhagic shock is the primary cause of preventable mortality in polytrauma patients, accounting for 50% of mortalities within 24 h of hospital admission. Aim To evaluate the predictive value of the shock index (SI) and the assessment of blood consumption (ABC) score in polytrauma patients concerning the need for a massive blood transfusion (MBT). Patients and methods This was a prospective comparative study conducted on 300 polytrauma patients who were transported directly to the Emergency Department at Tanta University Hospital. Ninety-one patients needed MBT due to chest and abdominal trauma according to the SI and ABC score, and 209 patients did not need MBT. Results SI can significantly predict massive blood need (area under the curve=0.957 and P <0.001) at a cut-off of 1 with 90.11% sensitivity, 80.4% positive predictive value, 90.43% specificity, and 95.5% negative predictive value. ABC score can significantly predict massive blood need (area under the curve=0.906 and P <0.001) at a cut-off of 2 with 64.84% sensitivity, 86.8% positive predictive value, 95.69% specificity, and 86.2% negative predictive value. The SI was a significant predictor of MBT than the ABC score. Conclusion SI and ABC scores were significant predictors of MBT. SI proved to be more sensitive than ABC. There is a significant correlation between these scores and factors as trauma type, heart rate, blood pressure, and mortality. This highlights the importance of using these scoring systems as reliable tools in trauma care for the timely and effective management of patients.