Índice de choque y capacidad para predecir el uso de transfusión masiva en una población con trauma grave en región toracoabdominal

Abstract

Introduction

Bleeding is one of the main causes of death associated with trauma. Massive transfusion (MT) is one of the mainstays of treatment, with decreased mortality demonstrated with early initiation of administration. There are multiple tools to activate MT protocols, among which is the shock index (CI), however, the cut-off point to define its activation is not clear. The objective of this study was to determine the diagnostic performance of IC to determine the need for MT in patients with severe trauma to the chest and/or abdomen.

Methodology

Cross sectional study. Patients with severe trauma were evaluated between the years 2017 to 2022. The incidence of MT was estimated and the CI of each patient with the first medical contact was calculated. Discrimination was assessed using AUC-ROC for receiving a MT.

Results

The cumulative MT incidence was 30.79% (n = 97); In patients who required MT the median CI was 1.2 (IQR: 0.6-1.8), while in patients who did not require MT it was 1 (IQR: 0.5-1.5). The cut-off point of 1.1 in the CI presented the best performance with an AUC-ROC 0.63 to predict the need for MT.

Conclusion

In the sample analyzed, the CI has a poor performance in predicting the need for MT, although it was observed that a higher CI is related to greater administration of MT, with an optimal cut-off point of 1.1 for our population.