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Prediction of mortality and of the need for massive transfusion in casualties arriving at combat support hospitals in Iraq.
J Trauma. 2008 Feb; 64(2 Suppl):S51-5; discussion S55-6.JT

Abstract

BACKGROUND

Our purpose was to compare the Revised Trauma Score (RTS) with the new Field Triage Score (FTS) for prediction of mortality (MORT) and of need for massive transfusion (MASS, >or=10 units of packed cells or whole blood) in casualties arriving at combat support hospitals in Iraq.

METHODS

Six hundred ninety-two cases were reviewed; 536 had complete data and were included. Total Glasgow Coma Scale score (GCS total) not GCS motor was used. Thus, a modification (FTS 07) of the FTS was calculated, using GCS <8 and systolic arterial pressure (SAP) <100 as cut-points, with range 0 to 2. Variables different by univariate analysis underwent logistic regression analysis (LRA) and areas under the curve for receiver operating characteristic curves (AUC) were calculated. By LRA, probability of an outcome is given by p = e(k)/(1 + e(k)).

RESULTS

By LRA for MORT, k = 0.616 - 0.438 x RTS; AUC = 0.708. When used instead of RTS, FTS 07 provided k = -0.716 - 1.009 x FTS 07; AUC = 0.687 (NS). For MASS, k = 0.638 - 0.115 x RTS - 0.011 x DAP + 0.358 x SI, where DAP is diastolic arterial pressure and SI is shock index, i.e., heart rate or SAP; AUC = 0.638. When used instead of RTS, FTS 07 provided k = -0.740 - 0.376 x FTS 07- 0.011 x DAP; AUC = 0.618 (NS).

CONCLUSIONS

RTS emerged as the best predictor of MORT, with FTS 07 a close surrogate. This indicates the effect of impaired mentation on MORT in these data. For prediction of MASS, RTS as well as the heart rate and blood pressure predominated. The advantage of FTS 07 (or original FTS) over RTS is the former's ease of computation.

Authors+Show Affiliations

US Army Institute of Surgical Research, Fort Sam Houston, TX 78234, USA. lee.cancio@us.army.milNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

18376172

Citation

Cancio, Leopoldo C., et al. "Prediction of Mortality and of the Need for Massive Transfusion in Casualties Arriving at Combat Support Hospitals in Iraq." The Journal of Trauma, vol. 64, no. 2 Suppl, 2008, pp. S51-5; discussion S55-6.
Cancio LC, Wade CE, West SA, et al. Prediction of mortality and of the need for massive transfusion in casualties arriving at combat support hospitals in Iraq. J Trauma. 2008;64(2 Suppl):S51-5; discussion S55-6.
Cancio, L. C., Wade, C. E., West, S. A., & Holcomb, J. B. (2008). Prediction of mortality and of the need for massive transfusion in casualties arriving at combat support hospitals in Iraq. The Journal of Trauma, 64(2 Suppl), S51-5; discussion S55-6. https://doi.org/10.1097/TA.0b013e3181608c21
Cancio LC, et al. Prediction of Mortality and of the Need for Massive Transfusion in Casualties Arriving at Combat Support Hospitals in Iraq. J Trauma. 2008;64(2 Suppl):S51-5; discussion S55-6. PubMed PMID: 18376172.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prediction of mortality and of the need for massive transfusion in casualties arriving at combat support hospitals in Iraq. AU - Cancio,Leopoldo C, AU - Wade,Charles E, AU - West,Susan A, AU - Holcomb,John B, PY - 2008/4/11/pubmed PY - 2008/5/15/medline PY - 2008/4/11/entrez SP - S51-5; discussion S55-6 JF - The Journal of trauma JO - J Trauma VL - 64 IS - 2 Suppl N2 - BACKGROUND: Our purpose was to compare the Revised Trauma Score (RTS) with the new Field Triage Score (FTS) for prediction of mortality (MORT) and of need for massive transfusion (MASS, >or=10 units of packed cells or whole blood) in casualties arriving at combat support hospitals in Iraq. METHODS: Six hundred ninety-two cases were reviewed; 536 had complete data and were included. Total Glasgow Coma Scale score (GCS total) not GCS motor was used. Thus, a modification (FTS 07) of the FTS was calculated, using GCS <8 and systolic arterial pressure (SAP) <100 as cut-points, with range 0 to 2. Variables different by univariate analysis underwent logistic regression analysis (LRA) and areas under the curve for receiver operating characteristic curves (AUC) were calculated. By LRA, probability of an outcome is given by p = e(k)/(1 + e(k)). RESULTS: By LRA for MORT, k = 0.616 - 0.438 x RTS; AUC = 0.708. When used instead of RTS, FTS 07 provided k = -0.716 - 1.009 x FTS 07; AUC = 0.687 (NS). For MASS, k = 0.638 - 0.115 x RTS - 0.011 x DAP + 0.358 x SI, where DAP is diastolic arterial pressure and SI is shock index, i.e., heart rate or SAP; AUC = 0.638. When used instead of RTS, FTS 07 provided k = -0.740 - 0.376 x FTS 07- 0.011 x DAP; AUC = 0.618 (NS). CONCLUSIONS: RTS emerged as the best predictor of MORT, with FTS 07 a close surrogate. This indicates the effect of impaired mentation on MORT in these data. For prediction of MASS, RTS as well as the heart rate and blood pressure predominated. The advantage of FTS 07 (or original FTS) over RTS is the former's ease of computation. SN - 1529-8809 UR - https://www.unboundmedicine.com/medline/citation/18376172/Prediction_of_mortality_and_of_the_need_for_massive_transfusion_in_casualties_arriving_at_combat_support_hospitals_in_Iraq_ L2 - https://doi.org/10.1097/TA.0b013e3181608c21 DB - PRIME DP - Unbound Medicine ER -