Journal of The Korean Society of Emergency Medicine (대한응급의학회지)

The Korean Society of Emergency Medicine (대한응급의학회)
권호 표지

Initial D-dimer level as early prognostic tool in blunt trauma patients without significant brain injury

중증 뇌손상이 없는 둔상 환자에서 초기 중증도 예측인자로서 D-dimer의 역할

  • Sohn, Seok Woo (Department of Emergency Medicine, Research Institute of Clinical Medicine of Chonbuk National University and Biomedical Research Institue of Chonbuk National University Hospital) ;
  • Lee, Jae Baek (Department of Emergency Medicine, Research Institute of Clinical Medicine of Chonbuk National University and Biomedical Research Institue of Chonbuk National University Hospital) ;
  • Jin, Young Ho (Department of Emergency Medicine, Research Institute of Clinical Medicine of Chonbuk National University and Biomedical Research Institue of Chonbuk National University Hospital) ;
  • Jeong, Tae Oh (Department of Emergency Medicine, Research Institute of Clinical Medicine of Chonbuk National University and Biomedical Research Institue of Chonbuk National University Hospital) ;
  • Jo, Si On (Department of Emergency Medicine, Research Institute of Clinical Medicine of Chonbuk National University and Biomedical Research Institue of Chonbuk National University Hospital) ;
  • Lee, Jeong Moon (Trauma Team, Chonbuk National University Hospital) ;
  • Yoon, Jae Chol (Department of Emergency Medicine, Research Institute of Clinical Medicine of Chonbuk National University and Biomedical Research Institue of Chonbuk National University Hospital) ;
  • Kim, So Eun (Department of Emergency Medicine, Research Institute of Clinical Medicine of Chonbuk National University and Biomedical Research Institue of Chonbuk National University Hospital)
  • 손석우 (전북대학교 의학전문대학원 응급의학교실 (전북대학교 임상의학 연구소/전북대학교병원 의생명 연구원)) ;
  • 이재백 (전북대학교 의학전문대학원 응급의학교실 (전북대학교 임상의학 연구소/전북대학교병원 의생명 연구원)) ;
  • 진영호 (전북대학교 의학전문대학원 응급의학교실 (전북대학교 임상의학 연구소/전북대학교병원 의생명 연구원)) ;
  • 정태오 (전북대학교 의학전문대학원 응급의학교실 (전북대학교 임상의학 연구소/전북대학교병원 의생명 연구원)) ;
  • 조시온 (전북대학교 의학전문대학원 응급의학교실 (전북대학교 임상의학 연구소/전북대학교병원 의생명 연구원)) ;
  • 이정문 (전북대학교병원 외상팀) ;
  • 윤재철 (전북대학교 의학전문대학원 응급의학교실 (전북대학교 임상의학 연구소/전북대학교병원 의생명 연구원)) ;
  • 김소은 (전북대학교 의학전문대학원 응급의학교실 (전북대학교 임상의학 연구소/전북대학교병원 의생명 연구원))
  • Received : 2018.07.02
  • Accepted : 2018.09.03
  • Published : 2018.10.31

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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.

Keywords

References

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