'Time to TASH': How long does complete score calculation take to assess major trauma hemorrhage?

摘要

Uncontrolled haemorrhage is still one of the leading causes of death within trauma patients (Evans et al, 2010) and is often exaggerated by the presence of acute traumatic coagulopathy (ATC) (Maegele et al, 2007). Despite substantial improvements in acute trauma care over the past decade, the rapid identification of patients with substantial ongoing bleeding and at risk for massive transfusion remains insufficient. Recently, our group has developed and validated the Trauma-Associated Severe Hemorrhage (TASH)-Score (Yiicel et al, 2006; Maegele et al, 2011; Brockamp et al, 2012), as an easy-to-calculate and valid scoring system to predict the individual's probability for massive transfusion, as a surrogate for life-threatening hemorrhage after multiple trauma. A major criticism of the score has been its potential lack in timely calculation during early trauma resuscitation. In this study, the time to complete TASH calculation was prospectively assessed in a cohort of trauma patients admitted to our level-1 trauma center.