Blunt Trauma Massive Transfusion (B-MaT) Score: A Novel Scoring Tool

Area of Science:

• Trauma Surgery
• Emergency Medicine
• Hemorrhagic Shock Management

Background:

• Existing massive transfusion (MT) prediction tools lack immediate variables and fail to differentiate blunt trauma mechanisms by force.
• There is a need for a specific tool to predict MT in blunt trauma patients (BTPs) considering diverse blunt force mechanisms.

Purpose of the Study:

• To develop and validate a novel scoring tool, the Blunt trauma Massive Transfusion (B-MaT) score.
• To predict the requirement for MT in BTPs prior to their arrival at the hospital.

Main Methods:

• Utilized the 2017 Trauma Quality Improvement Program database for BTPs, randomly divided into derivation and validation sets.
• Developed logistic regression models to identify independent predictors of MT (≥6 units PRBCs within 4h or ≥10 units within 24h).
• Derived the B-MaT score based on weighted predictors and calculated the area under the receiver-operating curve (AROC).

Main Results:

• Identified heart rate ≥ 120 bpm, systolic blood pressure ≤ 90 mmHg, and high-risk blunt mechanisms as key predictors for MT.
• The B-MaT score (0-9) demonstrated increasing MT rates with higher scores (e.g., score 9: 32.4% MT rate).
• Achieved an AROC of 0.86 in the derivation set and 0.85 in the validation set, indicating good predictive accuracy.

Conclusions:

• The B-MaT score is a novel, pre-arrival tool for predicting MT needs in blunt trauma patients.
• Further prospective validation is recommended to confirm accuracy and evaluate its impact on patient outcomes and blood product allocation.