Using the pre-hospital shock index multiplied by the AVPU scale as a predictor of massive transfusion and coagulopathy in patients with trauma
- Author:
Young Hun CHOI
1
;
Seok-Ran YEOM
;
Sung-Wook PARK
;
Wook Tae YANG
;
Il Jae WANG
;
Won Ung TAE
;
Suck Ju CHO
;
Dae Sup LEE
;
Mun Ki MIN
;
Up HUH
;
Chanhee SONG
;
Yeaeun KIM
;
Youngmo CHO
Author Information
1. Department of Emergency Medicine, Pusan National University School of Medicine, Busan, Korea
- Publication Type:Original Article
- From:Journal of the Korean Society of Emergency Medicine
2024;35(3):223-230
- CountryRepublic of Korea
- Language:EN
-
Abstract:
Objective:This study evaluated the accuracy of the pre-hospital shock index multiplied by the AVPU scale (PSIAVPU) as a predictor of massive transfusion (MT) and traumatic coagulopathy.
Methods:This research was a retrospective single-center study that included patients consecutively presenting to a trauma center between 2017 and 2020. The predictive value of the PSIAVPU for MT, in-hospital mortality, and traumatic coagulopathy was measured using the area under the curve (AUC) of the receiver operating characteristic curve. The AUC of the PSIAVPU was compared with the Reverse Shock Index multiplied by the Glasgow Coma Scale (rSIG) measured at the trauma center presentation.
Results:One thousand seven hundred and ninety-two patients were included, of which 163 patients (9.09%) received MT and 195 patients (10.88%) died during their hospital stay. Traumatic coagulopathy was observed in 245 patients. The AUC values for the PSIAVPU in terms of predicting MT, hospital mortality, and traumatic coagulopathy were 0.755, 0.752, and 0.736, respectively.
Conclusion:In patients with trauma, the predictive power of the PSIAVPU was higher than that of the prehospital shock index and was comparable to that of the rSIG. The PSIAVPU is a useful indicator that can be used easily and quickly for trauma patients at the prehospital stage.
