retrospective Testing classification of shock The only direct comparison made with analysis on 21853 using four of worsening BD classification system was to predict “strata” patients derived index” as alternative to requirement for transfusion AUROC “shock – from the base deficit classification. was similar. TraumaRegister DGU Divided into 4 arbitrary strata of shock using SI (33/55/10/5% in each group) Looked at transfusion requirements/clotting (plts and days/MOF/sepsis. Compared SI and BD AUROC for predicting transfusion requirement (requirement for 1U or more blood). Mutschler M Renaissance of TraumaRegister DGU (2002 When classified by BD: new classification – “The et al 2013 base deficit for the SBP fell as shock group increased, HR discriminates better the need for early initial assessment N = increased as shock group increased: blood product transfusion and of trauma patients: Mean ISS >>15 1 (BD <2): SBP 132 HR 86 mortality in severely injured patients a base Group 4 (BD >10): SBP 95 HR 97 than the current ATLS classification classification for Divided into four groups of of hypovolaemic shock.” hypovolaemic worsening BD and compared BD distinguished more precisely shock developed vital signs, laboratory between patients at risk of dying than the on data from parameters, ISS, transfusion current ATLS classification of 16305 patients requirements and mortality hypovolaemic shock: derived from the between groups. TraumaRegister BD: DGU Compared BD-classification to Class 1: 7% mortality classification” based Class 4: 51% mortality “ATLS – on worst vital sign from HR/SBP or GCS (used arbitrary values ATLS: where values not explicitly stated Class 1: 2% mortality by ATLS system) Class 4: 31% mortality Mutschler et A critical TraumaRegister DGU (2002 9.3% of patient had signs as ATLS classification of – “The al 2013 reappraisal of the 2010) suggested by ATLS classification. hypovolaemic shock might be ATLS N = 36504 academically and didactical classification of appealing as an easy and fast hypovolaemic assessment of multiply injured
retrospective analysis on 21853 patients derived from the TraumaRegister DGU Testing classification of shock using four “strata” of worsening “shock index” as alternative to base deficit classification. Divided into 4 arbitrary strata of shock using SI (33/55/10/5% in each group) Looked at transfusion requirements/clotting (plts and days/MOF/sepsis. Compared SI and BD AUROC for predicting transfusion requirement (requirement for 1U or more blood). The only direct comparison made with BD classification system was to predict requirement for transfusion – AUROC was similar. Mutschler M et al 2013 Renaissance of base deficit for the initial assessment of trauma patients: a base classification for hypovolaemic shock developed on data from 16305 patients derived from the TraumaRegister DGU TraumaRegister DGU (2002 – N = Mean ISS >>15 Divided into four groups of worsening BD and compared vital signs, laboratory parameters, ISS, transfusion requirements and mortality between groups. Compared BD-classification to “ATLS classification” – based on worst vital sign from HR/SBP or GCS (used arbitrary values where values not explicitly stated by ATLS system) When classified by BD: SBP fell as shock group increased, HR increased as shock group increased: 1 (BD <2): SBP 132 HR 86 Group 4 (BD >10): SBP 95 HR 97 BD distinguished more precisely between patients at risk of dying than the current ATLS classification of hypovolaemic shock: BD: Class 1: 7% mortality Class 4: 51% mortality ATLS: Class 1: 2% mortality Class 4: 31% mortality “The new classification discriminates better the need for early blood product transfusion and mortality in severely injured patients than the current ATLS classification of hypovolaemic shock.” Mutschler et al 2013 A critical reappraisal of the ATLS classification of hypovolaemic TraumaRegister DGU (2002 – 2010) N = 36504 9.3% of patient had signs as suggested by ATLS classification. “The ATLS classification of hypovolaemic shock might be academically and didactical appealing as an easy and fast assessment of multiply injured
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