Validation of the BATT score for prehospital risk stratification of traumatic haemorrhagic death: usefulness for tranexamic acid treatment criteria.

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_6E755CC986B5
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Validation of the BATT score for prehospital risk stratification of traumatic haemorrhagic death: usefulness for tranexamic acid treatment criteria.
Journal
Scandinavian journal of trauma, resuscitation and emergency medicine
Author(s)
Ageron F.X., Coats T.J., Darioli V., Roberts I.
ISSN
1757-7241 (Electronic)
ISSN-L
1757-7241
Publication state
Published
Issued date
06/01/2021
Peer-reviewed
Oui
Volume
29
Number
1
Pages
6
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Tranexamic acid reduces surgical blood loss and reduces deaths from bleeding in trauma patients. Tranexamic acid must be given urgently, preferably by paramedics at the scene of the injury or in the ambulance. We developed a simple score (Bleeding Audit Triage Trauma score) to predict death from bleeding.
We conducted an external validation of the BATT score using data from the UK Trauma Audit Research Network (TARN) from 1st January 2017 to 31st December 2018. We evaluated the impact of tranexamic acid treatment thresholds in trauma patients.
We included 104,862 trauma patients with an injury severity score of 9 or above. Tranexamic acid was administered to 9915 (9%) patients. Of these 5185 (52%) received prehospital tranexamic acid. The BATT score had good accuracy (Brier score = 6%) and good discrimination (C-statistic 0.90; 95% CI 0.89-0.91). Calibration in the large showed no substantial difference between predicted and observed death due to bleeding (1.15% versus 1.16%, P = 0.81). Pre-hospital tranexamic acid treatment of trauma patients with a BATT score of 2 or more would avoid 210 bleeding deaths by treating 61,598 patients instead of avoiding 55 deaths by treating 9915 as currently.
The BATT score identifies trauma patient at risk of significant haemorrhage. A score of 2 or more would be an appropriate threshold for pre-hospital tranexamic acid treatment.
Keywords
Bleeding, Prognostic model, Score, Tranexamic acid, Trauma
Pubmed
Web of science
Open Access
Yes
Create date
25/01/2021 14:28
Last modification date
24/02/2021 8:09
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