The following is a summary of “Development and validation of the tic score for early detection of traumatic coagulopathy upon hospital admission: a cohort study,” published in the May 2024 issue of Critical Care by Brac et al.
Researchers conducted a retrospective study to develop and validate a clinical score for the early identification of trauma-induced coagulopathy (TIC) upon hospital admission.
They derived the score from a level-1 trauma center registry (training set) and then validated it using data from two other level-1 trauma centers: initially on a trauma registry (retrospective validation set) and subsequently on a prospective cohort (prospective validation set). The TIC was defined as a PT ratio > 1.2 at hospital admission. Prehospital data (vital signs and resuscitation care) and admission data (vital signs and laboratory parameters) were collected. Parameters independently associated with TIC were included in the score (binomial logistic regression). The performance score for predicting TIC was then evaluated.
The results showed 3,489 patients, TIC was observed in 22% (95% CI 21–24%) of cases. Five criteria were identified and integrated into the TIC Score: Glasgow Coma Scale < 9, Shock Index > 0.9, hemoglobin < 11 g.dL −1, prehospital fluid volume > 1000 ml, and prehospital use of norepinephrine (yes/no). The score, ranging from 0 to 9 points, strongly identified TIC (AUC: 0.82, 95% CI: 0.81–0.84) across all three sets. A score value < 2 yielded a negative predictive value of 93% for ruling out TIC. A score value ≥ 6 had a good predictive value of 92% for indicating TIC.
Investigators concluded that the TIC Score proved a quick and easy tool for accurately identifying patients with TIC upon hospital admission.
Source: ccforum.biomedcentral.com/articles/10.1186/s13054-024-04955-7