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The following is a summary of “Prehospital National Early Warning Score as a predictor of Massive Transfusion in adult trauma patients,” published in the November 2023 issue of Emergency Medicine by Kim, et al.

Previous research has demonstrated that an elevated prehospital National Early Warning Score (preNEWS) is linked to increased adverse outcomes in trauma patients. However, its role as a predictor for massive transfusion (MT) in trauma cases remains unexplored. For a study, researchers sought to assess the accuracy of preNEWS in forecasting MT and hospital mortality among trauma patients.

The analysis focused on adult trauma patients attended and transported by emergency medical services (EMS) from January 2018 to December 2019. The primary variable was the preNEWS calculated at the scene. Predictive abilities for MT and 24-hour mortality constituted the primary and secondary outcomes, respectively. The prognostic performance of preNEWS was compared with the shock index, modified shock index, reverse shock index, and reverse shock index multiplied by the Glasgow Coma Scale in the prehospital setting.

The study encompassed 41,852 patients, with 1,456 (3.5%) receiving MT. preNEWS exhibited the highest area under the receiver operating characteristic (AUROC) curve for predicting MT (0.8504; 95% CI, 0.840–0.860) and 24-hour mortality (AUROC 0.873; 95% CI, 0.863–0.883). The sensitivity of preNEWS for MT was 0.755, and its specificity was 0.793. All indices demonstrated a high negative predictive value and a low positive predictive value.

preNEWS emerged as a valuable and swift predictor for MT and 24-hour mortality in trauma patients. The calculation of preNEWS can aid decision-making at the scene, facilitating streamlined transfers to trauma centers and prompt initiation of advanced treatment.

Source: sciencedirect.com/science/article/abs/pii/S0735675723004436