Estudio piloto sobre escalas predictivas de transfusión masiva: ¿iguales en el paciente traumático que en el médico?

Abstract

Introduction and objectivesMassive bleeding and associated coagulation disorders are one of the main causes of mortality in critically ill patients. Current studies claim that the majority of massive bleeding is due to traumatic injury, but there is a lack of data about predictive scales and massive transfusion (MT) protocols in non-trauma patients. The objective of this study is to assess the applicability of using the massive transfusion prediction scores of trauma patients in non-trauma patients. MethodsA retrospective exploratory cohort study was conducted between January-December 2017 that included patients older than 18 years admitted to a multidisciplinary ICU of a tertiary hospital for non-traumatic diseases that required MT. An analysis was performed on the relationship between haemodynamic variables (blood pressure and heart rate), biochemistry (lactate, base excess, urea, creatinine, prothrombin activity, thromboplastin activity, INR), as well as the diagnostic group on admission and its association with MT. ResultsA total of 72 patients were included, of which 50 (69.44%) were male. The mean age was 64.33 years. No statistical significance was found in the analysis between the risk factors considered: age, gender, and cardiology history. The mortality was 82%. No statistical significance was found between mortality and haemodynamic variables, biochemical analytical results, or with the TASH (Trauma Associated Severe Haemorrhage score) and the ABC (Assessment of Blood Consumption) score. ConclusionsThe predictive scales used in the trauma scenario are not valid for non-trauma scenarios and would need to be modified. The association of MT with a mortality increase is confirmed.