Observational studyEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2025
Is pre-hospital haemoglobin an efficient marker of the need for transfusion and haemorrhagic shock in severe trauma patients? A retrospective observational study.
Observational study in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Sex-Specific Temporal Patterns of Haemoglobin and Haematocrit as Mortality Predictors in Polytrauma Patients: A Watson Trauma Pathway Explorer Analysis.Journal of clinical medicine · 2026Article
- Revised french military transfusion doctrine for large-scale combat operations: a consensus framework.Critical care (London, England) · 2026Review
- Predicting Adverse Events in Blunt Chest Trauma: A Novel Nomogram Integrating Vitals, Hemogram, and Comorbidities.The Kaohsiung journal of medical sciences · 2025Article
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Authors and funding
8 authors.
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Abstract
backgroundHaemorrhagic shock is the leading cause of preventable death among trauma patients. Early detection of severe haemorrhage is essential for initiating timely resuscitation and mobilizing resources for massive transfusion (MT) protocols and damage control procedures. This study aimed to assess the predictive value of prehospital haemoglobin (Hb) levels for the need for transfusion at admission, the presence of haemorrhagic shock (HS), and the necessity for MT or haemostatic surgery. Additionally, the study sought to compare the diagnostic accuracy of Hb with established multiparametric scores such as TASH, ABC, Red Flag, and Shock Index (SI).
methodsThis retrospective, single-centre study was conducted at the Military Teaching Hospital (HIA) Sainte Anne, Toulon, France, a Level 1 trauma centre, from January 1, 2015, to December 31, 2022. Trauma patients older than 16 years, with an Injury Severity Score (ISS) ≥ 15, and at least one prehospital Hb measurement were included. The primary outcome was the predictive ability of Hb for the need for transfusion at admission. Secondary outcomes included the prediction of HS, MT, and haemostatic surgery, compared to TASH, ABC, Red Flag, and SI scores.
resultsAmong 2731 trauma patients, 1040 had an ISS ≥ 15 and at least one prehospital Hb measurement. Of these, 227 (21.8%) exhibited HS. Hb levels predicted the need for transfusion at admission with an AUC of 0.82. Hb, along with TASH, ABC, Red Flag, and SI, significantly predicted HS, MT, and haemostatic surgery. Using a cut-off value of 11.45 g/dL, Hb predicted the need for transfusion in 79% of cases.
conclusionPrehospital Hb levels are as effective as established multiparametric scores in predicting the need for transfusion, HS, MT, and haemostatic surgery. Due to its simplicity and practicality, Hb can serve as an alternative to complex scoring systems in prehospital settings, potentially improving triage and treatment outcomes in civilian and military trauma care.
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