mTICCS and its inter-rater reliability to predict the need for massive transfusion in severely injured patients

[en] Purpose: The modified Trauma-Induced Coagulopathy Clinical Score (mTICCS) presents a new scoring system for the early detection of the need for a massive transfusion (MT). This easily applicable score was validated in a large trauma cohort and proven comparable to more established complex scoring systems. However, the inter-rater reliability of the mTICCS has not yet been investigated. Methods: Therefore, a dataset of 15 randomly selected and severely injured patients (ISS ≥ 16) derived from the database of a level I trauma centre (2010–2015) was used. Moreover, 15 severely injured subjects that received MT were chosen from the same databank. A web-based survey was sent to medical professionals working in the field of trauma care asking them to evaluate each patient using the mTICCS. Results: In total, 16 raters (9 residents and 7 specialists) completed the survey. Ratings from 15 medical professionals could be evaluated and led to an ICC of 0.7587 (95% Bootstrap confidence interval (BCI) 0.7149–0.8283). A comparison of working experience specific ICC (n = 7 specialists, ICC: 0.7558, BCI: 0.7076–0.8270; n = 8 residents, ICC: 0.7634, BCI: 0.7183–0.8335) showed no significant difference between the two groups (p = 0.67). Conclusion: In summary, reliability values need to be considered when making clinical decisions based on scoring systems. Due to its easy applicability and its almost perfect inter-rater reliability, even with non-specialists, the mTICCS might therefore be a useful tool to predict the early need for MT in multiple trauma. © 2020, The Author(s).

Disciplines :

Surgery

Author, co-author :

Horst, K.; Department of Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, RWTH Aachen University, Pauwelsstraße 30, Aachen, 52074, Germany

Lichte, P.; Department of Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, RWTH Aachen University, Pauwelsstraße 30, Aachen, 52074, Germany

Bläsius, F.; Department of Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, RWTH Aachen University, Pauwelsstraße 30, Aachen, 52074, Germany

Weber, C. D.; Department of Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, RWTH Aachen University, Pauwelsstraße 30, Aachen, 52074, Germany

Tonglet, Martin ; Université de Liège - ULiège

Kobbe, P.; Department of Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, RWTH Aachen University, Pauwelsstraße 30, Aachen, 52074, Germany

Heussen, N.; Department of Medical Statistics, RWTH Aachen University, Aachen, 52074, Germany, Medical School, Sigmund Freud Private University, Vienna, 1020, Austria

Hildebrand, F.; Department of Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, RWTH Aachen University, Pauwelsstraße 30, Aachen, 52074, Germany

Language :

English

Title :

mTICCS and its inter-rater reliability to predict the need for massive transfusion in severely injured patients

Publication date :

2020

Journal title :

European Journal of Trauma and Emergency Surgery

ISSN :

1863-9933

eISSN :

1863-9941

Publisher :

Urban & Vogel GmbH, Germany

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 02 January 2021

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