• Klemens Horst, Philipp Lichte, Felix Bläsius, Christian David Weber, Martin Tonglet, Philipp Kobbe, Nicole Heussen, and Frank Hildebrand.
• Department of Trauma and Reconstructive Surgery, University Hospital RWTH Aachen, RWTH Aachen University, Pauwelsstraße 30, 52074, Aachen, Germany. khorst@ukaachen.de.
• Eur J Trauma Emerg Surg. 2022 Feb 1; 48 (1): 367-372.

PurposeThe 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.MethodsTherefore, 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.ResultsIn 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).ConclusionIn 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).

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