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

Abstract Background Tranexamic acid reduces surgical blood loss and deaths from bleeding in trauma patients. must be given urgently, preferably by paramedics at the scene of injury or ambulance. We developed a simple score (Bleeding Audit Triage Trauma score) to predict death bleeding. Methods conducted an external validation BATT using data UK Research Network (TARN) 1st January 2017 31st December 2018. evaluated impact tranexamic treatment thresholds Results included 104,862 patients with severity 9 above. was administered 9915 (9%) Of these 5185 (52%) received prehospital acid. The had good accuracy (Brier = 6%) discrimination (C-statistic 0.90; 95% CI 0.89–0.91). Calibration large showed no substantial difference between predicted observed due (1.15% versus 1.16%, P 0.81). Pre-hospital 2 more would avoid 210 treating 61,598 instead avoiding 55 as currently. Conclusion identifies patient risk significant haemorrhage. A appropriate threshold for pre-hospital treatment.