Using the pre-hospital shock index multiplied by the AVPU scale as a predictor of massive transfusion and coagulopathy in patients with trauma

¹Department of Emergency Medicine, Pusan National University School of Medicine, Busan, Korea
²Biomedical Research Institute, Pusan National University Hospital, Busan, Korea
³Biomedical Research Institute, Pusan National University Yangsan Hospital, Yangsan, Korea
⁴Department of Thoracic and Cardiovascular Surgery, Pusan National University School of Medicine, Busan, Korea
⁵Medical Research Institute, Pusan National University, Busan, Korea
⁶Department of Health Care Management, Catholic University of Pusan, Busan, Korea

Correspondence

Youngmo Cho ,Tel: 051-240-8769, Fax: 051-240-7719, Email: specialkey7@naver.com,

Received: November 1, 2023; Revised: November 5, 2023 Accepted: November 6, 2023. Published online: June 30, 2024.

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.
Method:
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.

Key words: Shock; Wounds and injuries; Blood transfusion; Emergency medical services