Citation

Hampton DA, Lee TH, Diggs BS, McCully SP, Schreiber MA. Am. J. Surg. 2014; 207(5): 642-7; discussion 647.

Affiliation

Department of Trauma, Critical Care, and Acute Surgery, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Portland, OR 97239-3098, USA.

Copyright

(Copyright © 2014, Elsevier Publishing)

DOI

10.1016/j.amjsurg.2013.12.009

PMID

24630907

Abstract

BACKGROUND: Rapid thrombelastography (rTEG) is a real-time whole-blood viscoelastic coagulation assay. We hypothesized that admission rTEG and clinical data are independent predictors of trauma-related mortality.

METHODS: Prospective observational data (patient demographics, admission vital signs, laboratory studies, and injury characteristics) from trauma patients enrolled within 6 hours of injury were collected. Mann-Whitney U test and analysis of variance test assessed significance (P ≤.05). Logistic regression analyses determined the association of the studied variables with 24-hour mortality.

RESULTS: Seven hundred ninety-five trauma patients were enrolled, of which 55 died within 24 hours of admission. Admission variables which independently predicted 24-hour mortality were as follows: Glasgow Coma Scale ≤8, hemoglobin <11 g/dL, international normalized ratio >1.5, Ly30 >8%, and penetrating injury (P <.05). This 5-variable model's area under the receiver operator characteristic curve was.88. The Hosmer-Lemeshow goodness-of-fit test was.90.

CONCLUSIONS: This 5-variable model provides a rapid prediction of 24-hour mortality. The inclusion of rTEG Ly30 demonstrates the association of fibrinolysis with outcome and may support the early use of antifibrinolytic therapies.

Language: en