Clinical Research, Trauma and Vascular Surgery, Hamad General Hospital, Doha, Qatar. Clinical Medicine, Weill Cornell Medical College, Doha, Qatar. Department of Surgery, Trauma Surgery, Hamad General Hospital, Doha, Qatar. Department of Surgery, Westchester Medical Center and New York Medical College, Valhalla, New York, USA. Department of Emergency Medicine, Sarasota Memorial Hospital and Florida State University, Sarasota, Florida, USA.
BACKGROUND Uncontrolled bleeding is the main cause of the potential preventable death in trauma patients. Accordingly, we reviewed all the existing scores for massive transfusion posttraumatic hemorrhage and summarized their characteristics, thus making it easier for the reader to have a global view of these scores - how they were created, their accuracy and to which population they apply. METHODS
A narrative review with a systematic search method to retrieve the journal articles on the predictive scores or models for massive transfusion was carried out. A literature search using PubMed, SCOPUS and Google scholar was performed using relevant keywords in different combinations. The keywords used were "massive transfusion", "score", "model", "trauma" and "hemorrhage" in different combinations. The search was limited for full-text articles published in English language, human species and for the duration from 01 January, 1998 to 30 November, 2018. RESULTS The database search yielded 295 articles. The search was then restricted to the inclusion criteria which retrieved 241 articles. Duplicates were removed and full-texts were assessed for the eligibility to include in the review which resulted in inclusion of 24 articles. These articles identified 24 scoring systems including modified or revised scores. Different models and scores for identifying patients requiring massive transfusion in military and civilian settings have been described. Many of these scorings were complex with difficult calculation, while some were simple and easy to remember. CONCLUSIONS The current prevailing practice that is best described as institutional or provider centered should be supplemented with score based protocol with auditing and monitoring tools to refine it. This review summarizes the current scoring models in predicting the need for MT in civilian and military trauma. Several questions remain open; i.e., do we need to develop new score, merge scores, modify scores or adopt existing score for certain trauma setting?