HIGH D-DIMER LEVELS PREDICT A POOR OUTCOME IN PATIENTS WITH SEVERE TRAUMA, EVEN WITH HIGH FIBRINOGEN LEVELS ON ARRIVAL: A MULTICENTER RETROSPECTIVE STUDY

Shock
Mineji HayakawaKazutaka Nishiyama

Abstract

Elevated D-dimer level in trauma patients is associated with tissue damage severity and is an indicator of hyperfibrinolysis during the early phase of trauma. To investigate the interacting effects of fibrinogen and D-dimer levels on arrival at the emergency department for massive transfusion and mortality in severe trauma patients in a multicenter retrospective study. This study included 519 adult trauma patients with an injury severity score ≥16. Patients with ≥10 units of red cell concentrate transfusion and/or death during the first 24 h were classified as having a poor outcome. Receiver operating characteristic curve analysis for predicting poor outcome showed the optimal cut-off fibrinogen and D-dimer values to be 190 mg/dL and 38 mg/L, respectively. On the basis of these values, patients were divided into four groups: low D-dimer (<38 mg/L)/high fibrinogen (>190 mg/dL), low D-dimer (<38 mg/L)/low fibrinogen (≤190 mg/dL), high D-dimer (≥38 mg/L)/high fibrinogen (>190 mg/dL), and high D-dimer (≥38 mg/L)/low fibrinogen (≤190 mg/dL). The survival rate was lower in the high D-dimer/low fibrinogen group than in the other groups. Moreover, the survival rate was lower in the high D-dimer/high fibrinogen group than in the low D-d...Continue Reading

Citations

Sep 19, 2017·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·D H LeeY S Cho
Dec 15, 2017·Anesthesia and Analgesia·Philipp SteinOliver M Theusinger
Nov 7, 2018·The Journal of Trauma and Acute Care Surgery·Tetsuya YumotoAtsunori Nakao
Aug 24, 2017·Critical Care : the Official Journal of the Critical Care Forum·Mineji HayakawaKazutaka Nishiyama
Aug 25, 2020·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Mineji HayakwaMasahiro Ieko
Sep 8, 2020·Epidemiology and Infection·Daniel Martin Simadibrata, Anna Mira Lubis
Jun 23, 2020·The International Journal of Biological Markers·Ling QinYanqiu Wang
Mar 2, 2019·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Kenta IshiiTetsuya Matsuoka
Dec 6, 2019·Shock·Robert L BallJeffrey W Shupp
Jan 9, 2021·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Rakuhei NakamaTakashi Mato
Mar 15, 2021·BMC Bioinformatics·Richard M JiangLinda Petzold
Apr 3, 2021·The Journal of Trauma and Acute Care Surgery·Mark BarryShibani Pati

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Methods Mentioned

BETA
blood collection

Software Mentioned

SPSS
OCTET

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