ROC curve for hospital admission BD vs mortality: AUROC 0.701 Using cut off of 6mmol/L: Sensitivity 48.4% Specificity 81.3% Comparing univariate significance for mortality prediction: Regression coefficients: BD 0.1368 GCS -0.2544 HR 0.0113 SBP -0.0218 Mutschler M The impact of Trauma Register DGU 2002-11 signs: BD classification of “The et al 2014 severe traumatic >16 years Mean HR hypovolaemic shock is a useful injury on a Primary admission 1 84 clinical tool to early risk stratify – novel base deficit Complete dataset 2 89 patients and in need for early blood – based Severe TBI: AIS head 3 95 product transfusions” ≥3 – classification of 4 97 – hypovolaemic N=10201 shock Mean SBP Aim of study was to test the 1 132 – applicability of the BD 2 124 – classification in patients with 3 113 – severe TBI. 4 96 – Stratified into four BD groups of Mortality: increasing shock similar 1 16% – – methodology to 2013 paper. 2 22% – 3 36% – Looked at vital signs, laboratory 4 61% – and clinical outcomes. Quick’s value: 1 84% – 2 78% – 3 68% – 4 55% – Mutschler M The shock index TraumaRegister DGU Worsening index group was daily clinical practice the SI may “In et al 2013 revisited a fast 2011) associated with significant increase in be used to assess the presence of – guide to N = 21853 (93% blunt trauma) ISS, transfusion requirements and hypovolaemic shock if laboratory or transfusion Mean ISS >>15 mortality. POCT technology is not available.” requirement? A
ROC curve for hospital admission BD vs mortality: AUROC 0.701 Using cut off of 6mmol/L: Sensitivity 48.4% Specificity 81.3% Comparing univariate significance for mortality prediction: Regression coefficients: BD 0.1368 GCS -0.2544 HR 0.0113 SBP -0.0218 Mutschler M et al 2014 The impact of severe traumatic injury on a novel base deficit based classification of hypovolaemic shock Trauma Register DGU 2002-11 >16 years Primary admission Complete dataset Severe TBI: AIS head ≥3 N=10201 Aim of study was to test the applicability of the BD classification in patients with severe TBI. Stratified into four BD groups of increasing shock – similar methodology to 2013 paper. Looked at vital signs, laboratory and clinical outcomes. signs: Mean HR 1 – 84 2 – 89 3 – 95 4 – 97 Mean SBP 1 – 132 2 – 124 3 – 113 4 – 96 Mortality: 1 – 16% 2 – 22% 3 – 36% 4 – 61% Quick’s value: 1 – 84% 2 – 78% 3 – 68% 4 – 55% “The BD classification of hypovolaemic shock is a useful clinical tool to early risk stratify patients and in need for early blood product transfusions” Mutschler M et al 2013 The shock index revisited – a fast guide to transfusion requirement? A TraumaRegister DGU N = 21853 (93% blunt trauma) Mean ISS >>15 Worsening index group was associated with significant increase in ISS, transfusion requirements and mortality. “In daily clinical practice the SI may be used to assess the presence of hypovolaemic shock if laboratory or POCT technology is not available.” 2011)
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