Cosgriff et al identified risk factors associated with the development of severe coagulopathy in a trauma patient who has received massive blood transfusion. These can help to identify a patient who may benefit from more aggressive management. The authors are from the Denver Health Medical Center.
Patient selection: trauma patient who has received > 10 units of packed RBCs in 24 hours.
Parameters:
(1) arterial pH
(2) body temperature
(3) Injury Severity Score (ISS)
(4) systolic blood pressure
Parameter |
Findings |
Points |
arterial pH |
>= 7.10 |
0 |
|
< 7.10 |
1 |
body temperature |
>= 34°C |
0 |
|
< 34°C |
1 |
ISS |
<= 25 |
0 |
|
> 25 |
1 |
systolic blood pressure |
>= 70 mm Hg |
0 |
|
< 70 mm Hg |
|
total number of risk factors =
= SUM(points for all 4 parameters)
Interpretation:
• minimum score: 0
• maximum score: 4
• The higher the score the greater the risk for a severe coagulopathy. When 2 risk factors were present the risk was 39 to 49%. When all 4 were present the risk was 98%.
Specialty: Hematology Oncology, Clinical Laboratory, Surgery, general, Surgery, orthopedic, Emergency Medicine