The shock index predicts in-flight blood transfusion in aeromedical trauma patients

Emerg Med Australas. 2024 Apr 11. doi: 10.1111/1742-6723.14413. Online ahead of print.

Abstract

Objective: To define the utility of the Triage Revised Trauma Score (TRTS), GCS/Age/arterial Pressure (GAP) score, and shock index (SI) in predicting the need for in-flight blood product administration in civilian trauma patients transported by an aeromedical platform.

Methods: A retrospective chart review of 3582 aeromedical trauma cases was conducted. An initial TRTS, GAP score and SI were calculated for each patient, and the administration of in-flight blood products was also recorded. Receiver operating characteristic (ROC) curves were used to quantify the predictive discrimination of the TRTS, GAP score and SI on the need for in-flight blood product administration.

Results: The SI showed a superior predictive value compared to the TRTS and GAP score. The SI showed an area under the curve on the ROC curve of 0.85 in both primary and inter-hospital transfer cases, indicating reasonable predictive value.

Conclusion: The SI demonstrates favourable test characteristics for predicting the need for in-flight blood product administration. Prospective validation of these results is warranted.

Keywords: aeromedical retrieval; blood; prehospital and retrieval medicine (PHRM); transfusion; trauma.