ABC Score for Massive Transfusion


ABC Score for Massive Transfusion

The patients of trauma die in very little time due to hemorrhage. In order to further the flow of blood the medical science has launched the Massive transfusion protocols (MTPs). In order to stimulate MTPs, the Assessment of Blood Consumption (ABC) score has become renowned as an MTP.

What are the methods involved?

In the year 2016, Adult trauma patients were given treatment at University of Louisville Trauma Center. The stimulation with the help of ABC score was checked before from the data of the emergency department (ED). The site, period of stimulation, those patients making use of over 5 units of chocked red blood cells, product waste, and reasons related to initial activation by the medical experts, and deaths were taken into consideration.

What was the outcome?

The total number of patients involved in this study were 3,421. Out of them, more than 30% of patients who had succumbed to MTP activation done in accordance with the ABC made use of over 5 units of blood items in the time of a day of admitting. While they were compared with more than 60% of the patients who use clinical judgment. Around 75% of the stimulation of MTP from medical advice had been stimulated by the method of ABC in the Emergency Department.

Over 50% of the stimulating MTP with the medical advice was stimulated in the operation theatre and around 40% in the ED. More than 80% of the stimulations which happened in the operation room by medical advice might have been stimulated in the ED in case the method of ABC had been used. The score of the ABC score can result in more possible plasma waste which is fresh frozen (588 vs. 84 units) upon comparison with the assessment by the doctor.

What is the final verdict?

The ABC rule overvalues the requirement of massive transfusion and it can result in the rise of wasted items upon equating with assessment by the doctor, but its needs result in the stimulation of MTP before. The rule to activate MT must be based on medical insight and authenticated forecasting tools.

The ABC Score was created for the patient of trauma in order to help the doctors in deciding if there is a need for massive transfusion to help them. The official research which was done in the past investigated some 596 patients. The variables were separated as well which were analytical of massive transfusion in the 76 patients out of those 596 patients which needed greater or equal to 10 units of pRBCs in the initial recovery occurring in a day.

The ABC score evaluates a score of greater or equal to two and clinical variables numbering 4. It was discovered that there was an existence of a ¾ of reactivity and a 0.86 uniqueness for foreseeing the requirement of massive transfusion. The validation study conducted by Cotton in the year 2010, used the ABC score on 3 groups of patients having trauma. The groups consisted of 1604 patients and discovered the Net Present Value of 0.97 and the Positive Predictive Value of 0.55 according to the established concepts. The benefit of this study is that it makes use of variables not present in the laboratory in order to help patients in discovering if they require more blood items.