{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T20:45:51Z","timestamp":1790455551782,"version":"4.1.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,1,18]],"date-time":"2026-01-18T00:00:00Z","timestamp":1768694400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Institute of Health Carlos III","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000780","name":"European Union","doi-asserted-by":"publisher","award":["DTS23\/00010"],"award-info":[{"award-number":["DTS23\/00010"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]},{"name":"CIBER de Enfermedades Respiratorias"},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["CB22\/06\/00035"],"award-info":[{"award-number":["CB22\/06\/00035"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Early identification of trauma patients requiring emergency transfusion remains a critical challenge in prehospital critical care. Massive hemorrhage accounts for approximately 40% of trauma-related deaths and represents the most significant modifiable prognostic factor. Current assessment methods rely primarily on vital signs and physical examination, which have limited sensitivity for detecting compensated shock states.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a prospective, multicenter, derivation-validation study across three Spanish Emergency Medical Services systems from January 2021 through June 2025. Adult trauma patients (n\u2009=\u2009853) meeting \u201cCode 15\u201d criteria were enrolled from 37 advanced life support units and 6 helicopter emergency medical services. Point-of-care testing was performed prehospitally using the epoc\u00ae Blood Analysis System. The primary outcome was emergency transfusion (packed red blood cells or massive transfusion protocol activation) within 24\u2009h.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The derived prehospital transfusion score (PTS) incorporates seven variables: mean blood pressure, Glasgow Coma Scale, pH, calcium, hemoglobin, base excess, and lactate. PTS demonstrated superior discrimination capacity with an area under the curve of 0.881 (95% CI: 0.836\u20130.925) for emergency transfusion and 0.946 (95% CI: 0.915\u20130.977) for massive transfusion, significantly outperforming six previously validated scoring systems (P\u2009&amp;lt;\u20090.001 for most comparisons).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The PTS provides a novel, multidimensional approach for early identification of trauma patients requiring emergency transfusion by integrating sensitive biomarkers of tissue hypoperfusion, metabolic acidosis, and coagulopathy with traditional hemodynamic parameters. This scoring system could enhance prehospital triage and facilitate timely activation of massive transfusion protocols.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/qjmed\/hcag022","type":"journal-article","created":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T12:39:15Z","timestamp":1768394355000},"page":"610-618","source":"Crossref","is-referenced-by-count":5,"title":["Prehospital critical care prediction score for emergency transfusion requirements in major trauma: a multicenter validation study"],"prefix":"10.1093","volume":"119","author":[{"given":"Rub\u00e9n","family":"P\u00e9rez-Garc\u00eda","sequence":"first","affiliation":[{"name":"Emergency Department, Hospital Universitario Rio Hortega , Valladolid,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ra\u00fal","family":"L\u00f3pez-Izquierdo","sequence":"additional","affiliation":[{"name":"Emergency Department, Hospital Universitario Rio Hortega , Valladolid,","place":["Spain"]},{"name":"Faculty of Medicine, Universidad de Valladolid , Valladolid,","place":["Spain"]},{"name":"CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III , Madrid,","place":["Spain"]},{"name":"Valladolid Health Research Institute (IBioVALL) , Valladolid,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Eichinger","sequence":"additional","affiliation":[{"name":"Division of Anesthesiology and Intensive Care Medicine, Medical University of Graz , Graz,","place":["Austria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Del Pozo Vegas","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universidad de Valladolid , Valladolid,","place":["Spain"]},{"name":"Valladolid Health Research Institute (IBioVALL) , Valladolid,","place":["Spain"]},{"name":"Emergency Department, Hospital Cl\u00ednico Universitario, Valladolid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan F","family":"Delgado Benito","sequence":"additional","affiliation":[{"name":"Prehospital Critical Care, Emergency Medical Services (SACYL) , Valladolid,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"S\u00e1nchez Sober\u00f3n","sequence":"additional","affiliation":[{"name":"Prehospital Critical Care, Emergency Medical Services (SACYL) , Valladolid,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bego\u00f1a","family":"Polonio-L\u00f3pez","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Universidad de Castilla-La Mancha , Talavera de la Reina,","place":["Spain"]},{"name":"Technological Innovation Applied to Health Research Group (ITAS Group), Faculty of Health Sciences, University of de Castilla-La Mancha , Talavera de la Reina,","place":["Spain"]},{"name":"Health Care Evaluation Research Group (ECUSAL), Instituto de Investigaci\u00f3n Sanitaria de Castilla-La Mancha (IDISCAM) , Toledo,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Luis","family":"Mart\u00edn-Conty","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, Universidad de Castilla-La Mancha , Talavera de la Reina,","place":["Spain"]},{"name":"Technological Innovation Applied to Health Research Group (ITAS Group), Faculty of Health Sciences, University of de Castilla-La Mancha , Talavera de la Reina,","place":["Spain"]},{"name":"Health Care Evaluation Research Group (ECUSAL), Instituto de Investigaci\u00f3n Sanitaria de Castilla-La Mancha (IDISCAM) , Toledo,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5024-5108","authenticated-orcid":false,"given":"Ancor","family":"Sanz-Garc\u00eda","sequence":"additional","affiliation":[{"name":"Faculty of Health Sciences, 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