Predicting the need for massive transfusion in trauma patients: The Traumatic Bleeding Severity Score

Ogura, Takayuki MD; Nakamura, Yoshihiko MD; Nakano, Minoru MD, PhD; Izawa, Yoshimitsu MD; Nakamura, Mitsunobu MD, PhD; Fujizuka, Kenji MD; Suzukawa, Masayuki MD, PhD; Lefor, Alan T. MD, MPH

Journal of Trauma and Acute Care Surgery:

May 2014 - Volume 76 - Issue 5 - p 1243-1250

In the development phase, five predictors of massive transfusion were identified, including age, systolic blood pressure, the Focused Assessment with Sonography for Trauma scan, severity of pelvic fracture, and lactate level. The maximum TBSS is 57 points. In the validation study, the average TBSS in patients who received massive transfusion was significantly greater (24.2 [6.7]) than the score of patients who did not (6.2 [4.7]) (p < 0.01). The area under the receiver operating characteristic curve, sensitivity, and specificity for a TBSS greater than 15 points was 0.985 (significantly higher than the other scoring systems evaluated at 0.892 and 0.813, respectively), 97.4%, and 96.2%, respectively.

CONCLUSION
The TBSS is simple to calculate using an available iOS application and is accurate in predicting the need for massive transfusion. Additional multicenter studies are needed to further validate this scoring system and further assess its utility.