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Predictive value of modified early warning score for massive transfusion in patients with traumatic brain injury

BACKGROUND: Exsanguination can be fatal in patients with traumatic brain injury (TBI). We aimed to analyze and compare the prognostic performances of injury severity score (ISS), revised trauma score (RTS), shock index (SI), and modified early warning score (MEWS) for predicting massive transfusion...

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Autores principales: Chae, Hwa Rang, Lee, Dong Hun, Lee, Byung Kook, Kim, Dong Ki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Kare Publishing 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10315988/
https://www.ncbi.nlm.nih.gov/pubmed/35920415
http://dx.doi.org/10.14744/tjtes.2021.13611
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author Chae, Hwa Rang
Lee, Dong Hun
Lee, Byung Kook
Kim, Dong Ki
author_facet Chae, Hwa Rang
Lee, Dong Hun
Lee, Byung Kook
Kim, Dong Ki
author_sort Chae, Hwa Rang
collection PubMed
description BACKGROUND: Exsanguination can be fatal in patients with traumatic brain injury (TBI). We aimed to analyze and compare the prognostic performances of injury severity score (ISS), revised trauma score (RTS), shock index (SI), and modified early warning score (MEWS) for predicting massive transfusion (MT) in severe trauma patients with TBI. METHODS: In this retrospective observational study, severe trauma patients with TBI who visited our emergency department between January 2018 and December 2020 were included in the study. TBI was considered when abbreviated injury scale was 3 or higher. The primary outcome was MT. RESULTS: A total of 1108 patients were included, and MT was performed in 92 (8.3%) patients. Receiver operating characteristic analyses were performed to evaluate the accuracy of ISS, RTS, SI, and MEWS for predicting MT. The area under curves (AUCs) of ISS, SI, RTS, and MEWS for predicting MT were 0.725 (95% confidence interval [CI], 0.698–0.751), 0.676 (95% CI, 0.648–0.704), 0.769 (95% CI, 0.743–0.793), and 0.808 (95% CI, 0.784–0.831), respectively. The AUC of MEWS was significantly different from the AUCs of ISS and SI but not the AUC of RTS for predicting MT. In a multivariate analysis, Glasgow Coma Scale (odds ratio [OR], 0.856; 95% CI, 0.803–0.911), body temperature (OR, 0.596; 95% CI, 0.386–0.920), and fresh frozen plasma (OR, 2.031; 95% CI, 1.794–2.299) were independently associated with MT. MEWS (OR, 1.425; 95% CI, 1.256–1.618) was independently associated with MT after adjustment for confounders. CONCLUSION: MEWS may be a useful tool for predicting MT in severe trauma patients with TBI.
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spelling pubmed-103159882023-07-04 Predictive value of modified early warning score for massive transfusion in patients with traumatic brain injury Chae, Hwa Rang Lee, Dong Hun Lee, Byung Kook Kim, Dong Ki Ulus Travma Acil Cerrahi Derg Original Article BACKGROUND: Exsanguination can be fatal in patients with traumatic brain injury (TBI). We aimed to analyze and compare the prognostic performances of injury severity score (ISS), revised trauma score (RTS), shock index (SI), and modified early warning score (MEWS) for predicting massive transfusion (MT) in severe trauma patients with TBI. METHODS: In this retrospective observational study, severe trauma patients with TBI who visited our emergency department between January 2018 and December 2020 were included in the study. TBI was considered when abbreviated injury scale was 3 or higher. The primary outcome was MT. RESULTS: A total of 1108 patients were included, and MT was performed in 92 (8.3%) patients. Receiver operating characteristic analyses were performed to evaluate the accuracy of ISS, RTS, SI, and MEWS for predicting MT. The area under curves (AUCs) of ISS, SI, RTS, and MEWS for predicting MT were 0.725 (95% confidence interval [CI], 0.698–0.751), 0.676 (95% CI, 0.648–0.704), 0.769 (95% CI, 0.743–0.793), and 0.808 (95% CI, 0.784–0.831), respectively. The AUC of MEWS was significantly different from the AUCs of ISS and SI but not the AUC of RTS for predicting MT. In a multivariate analysis, Glasgow Coma Scale (odds ratio [OR], 0.856; 95% CI, 0.803–0.911), body temperature (OR, 0.596; 95% CI, 0.386–0.920), and fresh frozen plasma (OR, 2.031; 95% CI, 1.794–2.299) were independently associated with MT. MEWS (OR, 1.425; 95% CI, 1.256–1.618) was independently associated with MT after adjustment for confounders. CONCLUSION: MEWS may be a useful tool for predicting MT in severe trauma patients with TBI. Kare Publishing 2022-08-01 /pmc/articles/PMC10315988/ /pubmed/35920415 http://dx.doi.org/10.14744/tjtes.2021.13611 Text en Copyright © 2022 Turkish Journal of Trauma and Emergency Surgery https://creativecommons.org/licenses/by-nc/4.0/This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
spellingShingle Original Article
Chae, Hwa Rang
Lee, Dong Hun
Lee, Byung Kook
Kim, Dong Ki
Predictive value of modified early warning score for massive transfusion in patients with traumatic brain injury
title Predictive value of modified early warning score for massive transfusion in patients with traumatic brain injury
title_full Predictive value of modified early warning score for massive transfusion in patients with traumatic brain injury
title_fullStr Predictive value of modified early warning score for massive transfusion in patients with traumatic brain injury
title_full_unstemmed Predictive value of modified early warning score for massive transfusion in patients with traumatic brain injury
title_short Predictive value of modified early warning score for massive transfusion in patients with traumatic brain injury
title_sort predictive value of modified early warning score for massive transfusion in patients with traumatic brain injury
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10315988/
https://www.ncbi.nlm.nih.gov/pubmed/35920415
http://dx.doi.org/10.14744/tjtes.2021.13611
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