ArticleInjury2017
Early predictors for massive transfusion in older adult severe trauma patients.
Article in Injury, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- The 2023 WSES guidelines on the management of trauma in elderly and frail patients.World journal of emergency surgery : WJES · 2024Guideline
- Prognostic Accuracy of Massive Transfusion, Critical Administration Threshold, and Resuscitation Intensity in Assessing Mortality in Traumatic Patients with Severe Hemorrhage: a Meta-Analysis.Journal of Korean medical science · 2019Pooled it
- Utility of point of care viscoelastic haemostatic assays for trauma patients in the emergency department.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Observational
- Article
- Coagulopathy management of multiple injured patients - a comprehensive literature review of the European guideline 2019.EFORT open reviews · 2022Review
- The Addition of ROTEM Parameter Did Not Significantly Improve the Massive Transfusion Prediction in Severe Trauma Patients.Emergency medicine international · 2022Article
- Antiplatelet Therapy for Atherothrombotic Disease in 2022-From Population to Patient-Centered Approaches.Frontiers in cardiovascular medicine · 2022Review
- Comparison of a trauma comorbidity index with other measures of comorbidities to estimate risk of trauma mortality.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2021Article
- Agreement between arterial and venous blood gases in trauma resuscitation in emergency department (AGREE).European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2021Observational
- The impact of age and receipt antihypertensives to systolic blood pressure and shock index at injury scene and in the emergency department to predict massive transfusion in trauma patients.Scandinavian journal of trauma, resuscitation and emergency medicine · 2021Observational
- Management of Bleeding Events Associated with Antiplatelet Therapy: Evidence, Uncertainties and Pitfalls.Journal of clinical medicine · 2020Review
- The European guideline on management of major bleeding and coagulopathy following trauma: fifth edition.Critical care (London, England) · 2019Article
- Article
- Transfusion Decision Making in Pediatric Critical Illness.Pediatric clinics of North America · 2017Review
- External Validation of the Traumatic Bleeding Severity Score for the Predictive Accuracy of the Need for Massive Transfusion.Acute medicine & surgeryArticle
- Association between lung contusion volume and acute changes in fibrinogen levels: A single-center observational study.Acute medicine & surgeryArticle
Corrections and comments
- Commented on by
Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMany scoring systems for the early prediction of the need for massive transfusion (MT) have been reported; in most of these, vital signs are regarded as important. However, the validity of these scoring systems in older patients remains unclear because older trauma patients often present with normal vital signs. In this study, we investigated the effectiveness of previously described scoring systems, as well as risk factors that can provide early prediction of the need for MT in older severe trauma patients.
methodsWe prospectively collected data from a cohort of severe trauma patients (ISS ≥16 and age ≥16years) admitted from January 2007 to March 2015. Trauma Associated Severe Hemorrhage (TASH), Assessment of Blood Consumption (ABC), and Prince of Wales Hospital (PWH) scores were compared between a younger and an older group. Furthermore, the predictors associated with MT in older severe trauma patients were assessed using multivariable logistic regression analyses.
resultsThe area under the curve (AUC) was significantly smaller for older group than for younger group for all three scoring systems (p<0.05). The most important risk factors to predict the need for MT were related to anatomical factors including FAST results (odds ratio (OR): 5.58, 95% confidence interval (CI): 2.10-14.99), unstable pelvic fracture (OR: 21.56, 95% CI: 6.05-90.78), and long bone open fracture of the lower limbs (OR: 12.21, 95% CI: 4.04-39.09), along with pre-injury anticoagulant agent use (OR: 5.22, 95% CI: 1.30-19.61), antiplatelet agent use (OR: 3.81, 95% CI: 1.57-9.04), lactate levels (OR: 1.20, 95% CI: 1.04-1.39) and shock index (OR: 2.67, 95% CI: 1.05-6.84). Traditional vital signs were not early risk factors.
conclusionWe suggest that MT in older trauma patients should be considered on the basis of anatomical factors, pre-injury anticoagulant or antiplatelet agent use, lactate level and SI even if traditional vital signs are normal.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.