Comparison between “fibrinogen and base deficit level” and modified trauma bleeding severity score in predicting the need for massive blood transfusion in trauma patients

Ismail, Monira T.; El-Beltagy, Yasmin M.; Ellabban, Gouda M.; Elshaboury, Islam M.

doi:10.4103/ejs.ejs_147_21

Comparison between “fibrinogen and base deficit level” and modified trauma bleeding severity score in predicting the need for massive blood transfusion in trauma patients

Authors

Abstract

Background
Severe trauma is a global public health issue. Approximately one in 10 mortalities is caused by traumatic injury, resulting in the annual global death of more than 5.8 million individuals. Massive hemorrhage is a major cause of death due to traumatic injury, and early administration of blood products with higher plasma and platelet ratio in trauma resuscitation is associated with decreased mortality. Fibrinogen (Fbg) and base-deficit (BD) levels might also be useful indicators for the need for massive transfusion. However, Modified Trauma-Bleeding Severity Score (TBSS) requires the assessment of several factors, such as vital signs, Focused Assessment with Sonography for Trauma, and pelvic and/or femoral fracture, making them slightly complicated. Thus, we aim to improve the outcome of trauma patients in need of massive blood transfusion at the emergency departments.
Patients and methods
This was a cross-sectional analytic study performed on two groups, with each group involving 35 patients. Fbg and BD levels were assessed in the first group, whereas the Modified TBSS of patients who attended to the Emergency Department of Suez Canal University Hospital was assessed in the second group.
Results
During clinical evaluation, respiratory rate was found to be statistically significant between Modified TBSS and Fbg (=0.04). Modified TBSS (80%) was more sensitive than Fbg (71.5%) and BD (73.3%) (<0.05). Furthermore, Modified TBSS (65%) was more specific than Fbg (60%) and BD (63%).
Conclusion
Focused Assessment with Sonography for Trauma and Modified TBSS are more sensitive and specific than BD and Fbg in predicting the need for massive transfusion.

Keywords