イチバ シンゴ   Ichiba Shingo
  市場 晋吾
   所属   医学部 医学科(東京女子医科大学病院)
   職種   教授
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Immediate screening method for predicting the necessity of massive transfusions in trauma patients: a retrospective single-center study.
掲載誌名 正式名:Journal of intensive care
略  称:J Intensive Care
ISSNコード:20520492/20520492
掲載区分国外
巻・号・頁 2(1),pp.54
著者・共著者 Yumoto Tetsuya, Iida Atsuyoshi, Hirayama Takahiro, Tsukahara Kohei, Shiba Naoki, Yamanouchi Hideo, Sato Keiji, Ugawa Toyomu, Ichiba Shingo, Ujike Yoshihito
発行年月 2014
概要 BACKGROUND:Hemostatic resuscitation might improve the survival of severely injured trauma patients. Our objective was to establish a simplified screening system for determining the necessity of massive transfusions (MT) at an early stage in trauma cases.METHODS:We retrospectively analyzed the cases of trauma patients who had been transported to our institution between November 2011 and October 2013. Patients who were younger than 18 years of age or who were confirmed to have suffered a cardiac arrest at the scene or on arrival were excluded. MT were defined as transfusions involving the delivery of ≥10 units of red blood cell concentrate within the first 24 h after arrival.RESULTS:A total of 259 trauma patients were included in this study (males: 178, 69%). Their mean age was 49 ± 20, and their median injury severity score was 14.4. Thirty-three (13%) of the patients required MT. The presence of a shock index of ≥1, a base excess of ≤ -3 mmol/L, or a positive focused assessment of sonography for trauma (FAST) result was found to exhibit sensitivity and specificity values of 0.97 and 0.81, respectively, for predicting the necessity of MT. Furthermore, this method displayed an area under the receiver operating characteristic curve of 0.934 (95% confidence interval, 0.891-0.978), which indicated that it was highly accurate.CONCLUSIONS:Our screening method based on the shock index, base excess, and FAST result is a simple and useful way of predicting the necessity of MT early after trauma.
DOI 10.1186/s40560-014-0054-3
PMID 25705412