The addition of ROTEM parameter did not significantly improve the massive transfusion prediction in severe trauma patients

Abstract

Abstract ObjectiveThis study aimed to assess whether rotational thermoelectrometry (ROTEM) data could improve the massive transfusion (MT) prediction model.MethodThis was a single-center, retrospective study. Patients who presented to the trauma center and underwent ROTEM between 2016 and 2020 were included. The primary and secondary outcomes were massive transfusion and in-hospital mortality, respectively. We constructed two models using multivariate logistic regression with backward conditional stepwise elimination (Model 1: without ROTEM parameter and Model 2: with ROTEM parameters). The area under the receiver operating characteristic curve (AUROC) was calculated to assess the predictive ability of the models.ResultIn total, 969 patients were included; 196 (20.2%) received MT. The in-hospital mortality rate was 14.1%. For MT, the AUROC was 0.854 (95% confidence interval [CI], 0.825-0.883) and 0.860 (95% CI, 0.832-0.888) for Model 1 and 2, respectively. For in-hospital mortality, the AUROC was 0.886 (95% CI, 0.857-0.915) and 0.889 (95% CI, 0.861-0.918) for Model 1 and 2, respectively. The AUROC values for Models 1 and 2 were not statistically different for either MT or in-hospital mortality.ConclusionWe found that addition of the ROTEM parameter did not significantly improve the predictive power of MT and in-hospital mortality in trauma patients.