Prognostic accuracy of massive transfusion, critical administration threshold, and resuscitation intensity in assessing mortality in traumatic patients with severe hemorrhage: A meta-analysis

Wu Seong Kang, In Soo Shin, Jung Soo Pyo, Sora Ahn, Seungwoo Chung, Young Jun Ki, Junepill Seok, Chan Yong Park, Sungdo Lee

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9 Scopus citations

Abstract

Background: The aim of this study was to assess the prognostic value of massive transfusion (MT), critical administration threshold (CAT), and resuscitation intensity (RI) for the mortality of trauma patients with severe hemorrhage. Methods: Seventeen relevant articles were obtained by searching the PubMed databases through February 15, 2019. The estimated mortality rates and injury severity scores were obtained through a meta-analysis. In addition, diagnostic test accuracy (DTA) reviews were conducted to obtain the sensitivity, specificity, diagnostic odds ratio, and the summary receiver operating characteristic curve. Results: At 24 hours, the estimated mortality rates were 0.194, 0.126, and 0.168 in assessments using MT, CAT, and RI, respectively. In addition, the pooled sensitivity of CAT (0.89; 95% confidence interval [CI], 0.82-0.94) was significantly higher than that of MT (0.63; 95% CI, 0.57-0.68) and RI (0.69; 95% CI, 0.63-0.75). Overall, the pooled specificity of MT and CAT was 0.82 (95% CI, 0.80-0.83) and 0.85 (95% CI, 0.83-0.88), respectively, while the pooled sensitivity was 0.49 (95% CI, 0.44-0.54) and 0.50 (95% CI, 0.38-0.62), respectively. Conclusion: CAT may be a more sensitive predictor for 24-hour mortality than other predictors. Furthermore, RI also appears to be a useful predictor for 24-hour mortality. Both MT and CAT showed high specificity for overall mortality.

Original languageEnglish
Article numbere318
JournalJournal of Korean Medical Science
Volume34
Issue number50
DOIs
StatePublished - 2019

Keywords

  • Hemorrhage
  • Injuries
  • Massive transfusion
  • Mortality
  • Trauma

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