Accepted Manuscript Title: ACCURACY OF SHOCK INDEX VERSUS ABC SCORE TO PREDICT NEED FOR MASSIVE TRANSFUSION IN TRAUMA PATIENTS Authors: Rebecca Schroll, David Swift, Danielle Tatum, Stuart Couch, Jiselle B. Heaney, Monica Llado-Farrulla, Shana Zucker, Frances Gill, Griffin Brown, Nicholas Buffin, Juan Duchesne PII: DOI: Reference:

S0020-1383(17)30625-3 http://dx.doi.org/10.1016/j.injury.2017.09.015 JINJ 7416

To appear in:

Injury, Int. J. Care Injured

Received date: Revised date: Accepted date:

5-7-2017 7-9-2017 14-9-2017

Please cite this article as: Schroll Rebecca, Swift David, Tatum Danielle, Couch Stuart, Heaney Jiselle B, Llado-Farrulla Monica, Zucker Shana, Gill Frances, Brown Griffin, Buffin Nicholas, Duchesne Juan.ACCURACY OF SHOCK INDEX VERSUS ABC SCORE TO PREDICT NEED FOR MASSIVE TRANSFUSION IN TRAUMA PATIENTS.Injury http://dx.doi.org/10.1016/j.injury.2017.09.015 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

ACCURACY OF SHOCK INDEX VERSUS ABC SCORE TO PREDICT NEED FOR MASSIVE TRANSFUSION IN TRAUMA PATIENTS

Rebecca Schroll, MD(1) David Swift, BS(1) Danielle Tatum, PhD(2) Stuart Couch, BS(1) Jiselle B. Heaney MD, MPH(1) Monica Llado-Farrulla, MD(1) Shana Zucker, BA(1) Frances Gill, BA(1) Griffin Brown, BS(1) Nicholas Buffin, BS(1) Juan Duchesne, MD(1)

Tulane School of Medicine, New Orleans, Louisiana (1) Our Lady of the Lake Regional Medical Center - Trauma Specialist Program, Baton Rouge, Louisiana (2)

Presented as a poster at the 74th Annual Meeting of AAST and Clinical Congress of Acute Care Surgery, September 9-12, 2015. The authors have no conflicts of interest to declare. Corresponding author: Rebecca W Schroll, MD Assistant Professor of Surgery Section of Trauma/Critical Care Tulane School of Medicine 1430 Tulane Ave, Dept of Surgery, #8622 New Orleans, LA 70112 Email: [email protected] Phone: 504-988-5111

Fax: 504-988-3683

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ABSTRACT Background: Various scoring systems have been developed to predict need for massive transfusion in traumatically injured patients. Assessments of Blood Consumption (ABC) score and Shock Index (SI) have been shown to be reliable predictors for Massive Transfusion Protocol (MTP) activation. However, no study has directly compared these two scoring systems to determine which is a better predictor for MTP activation. The primary objective was to determine whether ABC or SI better predicted the need for MTP in adult trauma patients with severe hemorrhage. Methods: This was a retrospective cohort study which included all injured patients who were trauma activations between January 1, 2009 and December 31, 2013 at an urban Level I trauma center. Patients 10 units PRBC transfusion within 24 hours of emergency department arrival. Sensitivity, specificity, and area under the receiver operating characteristic curve (AUROC) were used to evaluate scoring systems’ ability to predict effective MTP utilization. Results: A total of 645 patients had complete data for analysis. Shock Index ≥1 had sensitivity of 67.7% (95% CI 459.5% to 82.6%) and specificity of 81.3% (95% CI 78.0% to 84.3%) for predicting MTP, and ABC score ≥2 had sensitivity of 47.0% (95% CI 29.8% to 64.9%) and specificity of 89.8% (95% CI 87.2% to 92.1%). AUROC analyses showed SI to be the strongest predictor followed by ABC score with AUROC values of 0.83 and 0.74, respectively. SI had a significantly greater sensitivity (P = 0.035), but a significantly weaker specificity (P

Accuracy of shock index versus ABC score to predict need for massive transfusion in trauma patients.

Various scoring systems have been developed to predict need for massive transfusion in traumatically injured patients. Assessments of Blood Consumptio...
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