TY - JOUR
T1 - Prognostic accuracy of massive transfusion, critical administration threshold, and resuscitation intensity in assessing mortality in traumatic patients with severe hemorrhage
T2 - A meta-analysis
AU - Kang, Wu Seong
AU - Shin, In Soo
AU - Pyo, Jung Soo
AU - Ahn, Sora
AU - Chung, Seungwoo
AU - Ki, Young Jun
AU - Seok, Junepill
AU - Park, Chan Yong
AU - Lee, Sungdo
N1 - Publisher Copyright:
© 2019 The Korean Academy of Medical Sciences.
PY - 2019
Y1 - 2019
N2 - 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.
AB - 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.
KW - Hemorrhage
KW - Injuries
KW - Massive transfusion
KW - Mortality
KW - Trauma
UR - http://www.scopus.com/inward/record.url?scp=85077253026&partnerID=8YFLogxK
U2 - 10.3346/jkms.2019.34.e318
DO - 10.3346/jkms.2019.34.e318
M3 - Article
C2 - 31880415
AN - SCOPUS:85077253026
SN - 1011-8934
VL - 34
JO - Journal of Korean Medical Science
JF - Journal of Korean Medical Science
IS - 50
M1 - e318
ER -