Initial D-dimer level as early prognostic tool in blunt trauma patients without significant brain injury.
- Author:
Seok Woo SOHN
1
;
Jae Baek LEE
;
Young Ho JIN
;
Tae Oh JEONG
;
Si On JO
;
Jeong Moon LEE
;
Jae Chol YOON
;
So Eun KIM
Author Information
1. Department of Emergency Medicine, Research Institute of Clinical Medicine of Chonbuk National University and Biomedical Research Institue of Chonbuk National University Hospital, Jeonju, Korea. funny8303@naver.com
- Publication Type:Original Article
- Keywords:
Multiple trauma;
Blunt injury;
D-dimer;
Death;
Blood transfusion
- MeSH:
Blood Transfusion;
Brain Injuries*;
Brain*;
Humans;
Logistic Models;
Multiple Trauma;
Observational Study;
Odds Ratio;
Retrospective Studies;
ROC Curve;
Wounds, Nonpenetrating
- From:Journal of the Korean Society of Emergency Medicine
2018;29(5):430-436
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: The purpose of this study was to evaluate whether or not the d-dimer level indicating hyperfibrinolysis could be a predictor of early poor outcome (massive transfusion, death within 24 hours) associated with trauma-induced coagulopathy in blunt trauma without significant brain injury. METHODS: This study was a retrospective observational study using 516 blunt trauma patients without significant brain injury. The poor outcome group, including patients receiving massive transfusion and those who died within 24 hours, consisted of 33 patients (6.4%). The variables were compared between the poor outcome group and good outcome group, and logistic regression analysis was performed using statistically significant variables. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the poor outcome prediction ability of the initial d-dimer level. RESULTS: The poor outcome group showed more serious anatomical, physiological, and laboratory data than the good outcome group. In the ROC curve analysis for evaluation of the poor outcome prediction of the d-dimer level, the area under the curve value was 0.87 (95% confidence interval [CI], 0.84–0.90) while the cut-off value was 27.35 mg/L. In the logistic regression analysis, the high d-dimer level was shown to be an independent predictor of poor outcome (adjusted odds ratio, 14.87; 95% CI, 2.96–74.67). CONCLUSION: The high d-dimer level (>27.35 mg/L) can be used as a predictor for the poor outcome of patients with blunt trauma without significant brain injury.
