1. Relationship between Obesity and Massive Transfusion Needs in Trauma Patients, and Validation of TASH Score in Obese Population: A Retrospective Study on 910 Trauma Patients
- Author
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Pauline Deras, Orianne Martinez, Pascal Latry, Samir Jaber, Jonathan Charbit, Xavier Capdevila, Audrey De Jong, Physiologie & médecine expérimentale du Cœur et des Muscles [U 1046] (PhyMedExp), Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)-Centre National de la Recherche Scientifique (CNRS), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Service d'hématologie et oncologie médicale, Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Hôpital Lapeyronie-Université de Montpellier (UM), MORNET, Dominique, and Hôpital Lapeyronie-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-Université Montpellier 1 (UM1)-Université de Montpellier (UM)
- Subjects
Male ,Critical Care and Emergency Medicine ,Blood transfusion ,Physiology ,medicine.medical_treatment ,lcsh:Medicine ,Pathology and Laboratory Medicine ,Vascular Medicine ,Body Mass Index ,Injury Severity Score ,0302 clinical medicine ,Trauma Centers ,Medicine and Health Sciences ,030212 general & internal medicine ,lcsh:Science ,Trauma Medicine ,ComputingMilieux_MISCELLANEOUS ,education.field_of_study ,Trauma Severity Indices ,Multidisciplinary ,Mortality rate ,Trauma center ,Hematology ,Middle Aged ,Clinical Laboratory Sciences ,Hospitals ,Intensive Care Units ,Physiological Parameters ,Female ,Traumatic Injury ,Research Article ,Adult ,medicine.medical_specialty ,Death Rates ,Population ,Hemorrhage ,Young Adult ,03 medical and health sciences ,Signs and Symptoms ,Population Metrics ,Diagnostic Medicine ,Internal medicine ,medicine ,Humans ,Blood Transfusion ,Obesity ,education ,Demography ,Retrospective Studies ,Population Biology ,Transfusion Medicine ,business.industry ,Body Weight ,lcsh:R ,Biology and Life Sciences ,030208 emergency & critical care medicine ,Retrospective cohort study ,Surgery ,Health Care ,ROC Curve ,Health Care Facilities ,[SDV.SPEE] Life Sciences [q-bio]/Santé publique et épidémiologie ,People and Places ,Wounds and Injuries ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,lcsh:Q ,business ,Packed red blood cells ,Body mass index - Abstract
International audience; Background: Prediction of massive transfusion (MT) is challenging in management of trauma patients. However, MT and its prediction were poorly studied in obese patients. The main objective was to assess the relationship between obesity and MT needs in trauma patients. The secondary objectives were to validate the Trauma Associated Severe Hemorrhage (TASH) score in predicting MT in obese patients and to use a grey zone approach to optimize its ability to predict MT.Methods and Findings: An observational retrospective study was conducted in a Level I Regional Trauma Center Trauma in obese and non-obese patients. MT was defined as ≥10U of packed red blood cells in the first 24h and obesity as a BMI≥30kg/m². Between January 2008 and December 2012, 119 obese and 791 non-obese trauma patients were included. The rate of MT was 10% (94/910) in the whole population. The MT rate tended to be higher in obese patients than in non-obese patients: 15% (18/119, 95%CI 9‒23%) versus 10% (76/791, 95%CI 8‒12%), OR, 1.68 [95%CI 0.97‒2.92], p = 0.07. After adjusting for Injury Severity Score (ISS), obesity was significantly associated with MT rate (OR, 1.79[95%CI 1.00‒3.21], p = 0.049). The TASH score was higher in the obese group than in the non-obese group: 7(4–11) versus 5(2–10)(p
- Published
- 2016