Sage Journals: Discover world-class research

Abstract

Aim

We performed a retrospective investigation to determine the factors, including vital signs, severity of traumatic anatomical abnormality and biochemical data, which are most useful for predicting the outcomes of trauma patients after admission.

Methods

A retrospective medical chart review was performed for all trauma patients who were admitted to our department from September 2017 to August 2019. These subjects were then divided into two groups according to whether they survived to hospital discharge or not.

Results

During the investigation period, 790 patients were enrolled as subjects (Death group, n = 34; survival group, n = 756). The injury severity score, serum glucose level, prothrombin time, international normalized ratio and fibrin/fibrinogen degradation product level in the Death group were significantly greater than those in the Survival group. A multivariate analysis showed that the fibrin/fibrinogen degradation product level was a significant predictor of a fatal outcome (odds ratio 1.00, 95% confidence interval 1.0008-1.0040, p value = 0.0008).

Conclusions

The fibrin/fibrinogen degradation product levels on arrival may be a better predictor of a fatal outcome in trauma patients than physiological or anatomical severity.

Keywords

Fibrin/fibrinogen degradation product injury severity score predictor trauma

Get full access to this article

View all access options for this article.

References

Brohi

Cohen

Ganter

, et al. Acute coagulopathy of trauma: hypoperfusion induces systemic anticoagulation and hyperfibrinolysis. J Trauma 2008; 64: 1211–1217.

Ishii

Kinoshita

Kiridume

, et al. Impact of initial coagulation and fibrinolytic markers on mortality in patients with severe blunt trauma: a multicentre retrospective observational study. Scand J Trauma Resusc Emerg Med 2019; 27: 25.

Yanagawa

Ishikawa

Jitsuiki

, et al. Fibrinogen degradation product levels on arrival for trauma patients requiring a transfusion even without head injury. World J Emerg Med 2017; 8: 106–109.

Endo

Shiraishi

Otomo

, et al. Development of novel criteria of the “lethal triad” as an indicator of decision making in current trauma care: a retrospective multicenter observational study in Japan. Crit Care Med 2016; 44: e797–803.

Yousefzadeh-Chabok

Hosseinpour

Kouchakinejad-Eramsadati

, et al. Comparison of revised trauma score, injury severity score and trauma and injury severity score for mortality prediction in elderly trauma patients. Ulus Travma Acil Cerrahi Derg 2016; 22: 536–540.

Kim

, et al. The revised trauma score plus serum albumin level improves the prediction of mortality in trauma patients. Am J Emerg Med 2017; 35: 1882–1886.

Ley

Singer

Clond

, et al. Admission heart rate is a predictor of mortality. J Trauma Acute Care Surg 2012; 72: 943–947.

Boyd

Tolson

Copes

WS.

Evaluating trauma care: the TRISS method trauma score and the injury severity score. J Trauma 1987; 27: 370–378.

Champion

Copes

Sacco

, et al. A new characterization of injury severity. J Trauma 1990; 30: 539–545; discussion 545–546.

10.

Cook

Weddle

Baker

, et al. A comparison of the injury severity score and the trauma mortality prediction model. J Trauma Acute Care Surg 2014; 76: 47–52.

11.

Valderrama-Molina

Giraldo

Constain

, et al. Validation of trauma scales: ISS, NISS, RTS and TRISS for predicting mortality in a Colombian population. Eur J Orthop Surg Traumatol 2017; 27: 213–220.

12.

Winkelmann

Butz

Clausen

, et al. Admission blood glucose as a predictor of shock and mortality in multiply injured patients. SICOT J 2019; 5: 17.

13.

Patil

Srinivasarangan

Javali

, et al. Comparison of injury severity score, new injury severity score, revised trauma score and trauma and injury severity score for mortality prediction in elderly trauma patients. Indian J Crit Care Med 2019; 23: 73–77.

14.

Turtay

Kirimlioğlu

Ceylan

Coagulopathy in multiple traumas. Ulus Travma Acil Cerrahi Derg 2010; 16: 198–202.

15.

Johansson

Sørensen

Perner

, et al. Disseminated intravascular coagulation or acute coagulopathy of trauma shock early after trauma? An observational study. Crit Care 2011; 15: R272.

16.

Zhang

Liu

, et al. Correlation analysis between plasma D-dimer levels and orthopedic trauma severity. Chin Med J (Engl) 2012; 125: 3133–3136.

17.

Hagiwara

Oshima

Aoki

, et al. Usefulness of fibrin degradation products and d-dimer levels as biomarkers that reflect the severity of trauma. J Trauma Acute Care Surg 2013; 74: 1275–1278.

18.

Lee

Noh

, et al. High fibrin/fibrinogen degradation product to fibrinogen ratio is associated with 28-day mortality and massive transfusion in severe trauma. Eur J Trauma Emerg Surg 2018; 44: 291–298.

19.

Cohen

Christie

SA.

Coagulopathy of trauma. Crit Care Clin 2017; 33: 101–118.

20.

Bärtsch

Haeberli

Hauser

, et al. Fibrinogenolysis in the absence of fibrin formation in severe hypobaric hypoxia. Aviat Space Environ Med 1988; 59: 428–432.

21.

Muramatsu

Omori

Kushida

, et al. Clinical significance of the level of fibrin degradation products in drowning patients without cardiac arrest. J Rural Med 2020; 15: 201–203.

22.

Illig

Green

Ouriel

, et al. Primary fibrinolysis during supraceliac aortic clamping. J Vasc Surg 1997; 25: 244–251.

23.

Selladurai

Vickneswaran

Duraisamy

, et al. Coagulopathy in acute head injury-a study of its role as a prognostic indicator. Br J Neurosurg 1997; 11: 398–404.

24.

Saggar

Mittal

Vyas

MC.

Hemostatic abnormalities in patients with closed head injuries and their role in predicting early mortality. J Neurotrauma 2009; 26: 1665–1668.

The fibrin/fibrinogen degradation product level on arrival in trauma patients is a better predictor of a fatal outcome than physiological or anatomical severity: A retrospective chart review