Evaluation of Prince of Wales Hospital score in predicting massive blood transfusion in trauma

Abstract

Objective To evaluate the performance of Prince of Wales Hospital score (PWH score) in predicting the need for massive transfusion (MT) and comparing its performance with Assessment of Blood Consumption (ABC) score and the Trauma-associated Severe Hemorrhage (TASH) score. Background Because of the great risk of massive bleeding that may be life-threatening especially if uncontrolled, early prediction of ongoing bleeding and the need for MT reduce mortality of polytraumatized patients. PWH score was developed for the purpose of early prediction of need of MT. Patients and methods This is a prospective comparative study done on 61 polytraumatized patients, with Injury Severity Score more than or equal to 16, who presented to the Emergency Department of Menoufia University Hospital during the period from September 2017 to September 2018. PWH score was applied to assess its performance and comparing it with ABC and TASH scores. Results PWH, TASH, and ABC scores were applied on 61 patients with trauma meeting inclusion criteria to predict the need for MT. The area under the receiver operating characteristics curve was 0.92 for PWH score, 0.96 for TASH score, and 0.72 for ABC score. PWH was better in performance than ABC score, and TASH score was the most accurate and specific. Conclusion The results of this study support that TASH score has greater area under the (receiver operating characteristics) curve than PWH and ABC scores and is more accurate than both of them at cutoff point of more than or equal to 13.5. PWH performs better than ABC score at cutoff point of more than or equal to 4.5 for PWH and cutoff point of more than or equal to 1.5 for ABC score.