Fibrinogen degradation product levels on arrival for trauma patients requiring a transfusion even without head injury

doi:10.5847/wjem.j.1920-8642.2017.02.004

Abstract

Abstract:

BACKGROUND: There have been few reports on the clinical significance of the fibrinogen degradation product (FDP) level in trauma patients with and without head injury. We retrospectively analyzed trauma patients with or without head injury to investigate the clinical significance of the FDP level.

METHODS: From April 2013 to June 2015, a medical chart review was retrospectively performed for all patients with trauma. The exclusion criteria included patients who did not receive a transfusion. The patients were divided into two groups: a FDP>100 group, which included patients who had an FDP level on arrival over 100 ng/mL, and a FDP≤100 group.

RESULTS: The ratio of open fractures and the prothrombin ratio in the FDP>100 group were significantly smaller than those observed in the FDP≤100 group. The average age, ratio of blunt injury, Injury Severity Score (ISS), volume of transfusion and mortality ratio in the FDP>100 group were significantly greater than those in the FDP≤100 group. There was a weakly positive correlation between the FDP level and ISS (R=0.35, P=0.002), but it was not associated with the transfusion volume. The results of an analysis excluding patients with head injury showed a similar tendency.

CONCLUSION: The FDP levels may be a useful biochemical parameter for the initial evaluation of the severity of trauma and mortality even in blunt traumatized patients without head injury or with stable vital signs.

Key words: Fibrinogen degradation product, Injury Severity Score, Transfusion, Mortality

Youichi Yanagawa, Kouhei Ishikawa, Kei Jitsuiki, Toshihiko Yoshizawa, Yasumasa Oode, Kazuhiko Omori, Hiromichi Ohsaka. Fibrinogen degradation product levels on arrival for trauma patients requiring a transfusion even without head injury[J]. World Journal of Emergency Medicine, 2017, 8(2): 106-109.

Figures/Tables 3

Figure 1.

Table 1

Table 2

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Variables	FDP>100 (n=57)	FDP≤100 (n=44)	P value
Age (years)	66.8±2.7	58.3±3.0	<0.05
Sex (M/F)	30/27	31/13	0.10
Systolic blood pressure (mmHg)	103.5±5.5	118.2±6.9	n.s.
Heart rate (beats/minute)	83.4±3.5	85.3±3.9	n.s.
Glasgow Coma Scale	11.7±0.5	11.6±0.6	n.s.
Type of injury, n (%)			<0.01
Blunt	57 (100)	38 (86.4)
Penetrating	0	6 (13.6)
Mechanism of injury, n (%)
Traffic accident	44 (77.2)	25 (56.9)
Fall	13 (22.8)	9 (20.4)
Others	0	10 (22.7)
Injury Severity Score	19.7±1.4	13.3±1.7	<0.01
Open fracture, n (%)	6 (10.5)	12 (27.2)	<0.05
Ratio of cerebral lesions, n (%)	10 (17.5)	3 (6.8)	n.s.
Hemoglobin (g/dL)	10.9±0.2	11.1±0.3	n.s.
Creatinine phosphokinesis (IU/L)	561.5±65.0	645.2±208.9	n.s.
Prothrombin time (%)	78.2±3.4	89.0±3.7	<0.05
FDP (μg/mL)	330.3±52.7	37.2±4.2	<0.0001
Transfusion (U)	13.0±1.4	8.1±1.3	<0.05
Mortality rate, n (%)	12 (21.0)	2 (4.5)	<0.05

Variables	FDP>100 (n=47)	FDP≤100 (n=41)	P value
Age (years)	68.0±2.5	58.5±3.0	0.01
Sex (M/F)	26/21	30/11	0.08
Systolic blood pressure (mmHg)	105.7±5.7	119.3±7.2	n.s.
Heart rate (beats/minute)	86.7±3.5	84.9±4.0	n.s.
Glasgow Coma Scale	12.2±0.6	11.8±0.6	n.s.
Type of injury, n (%)			<0.01
Blunt	47 (100)	35 (85.4)
Penetrating	0	6 (14.6)
Mechanism of injury, n (%)
Traffic accident	38 (80.9)	22 (53.8)
Fall	9 (19.1)	9 (21.9)
Others	0	10 (24.3)
Injury Severity Score	19.3±1.7	13.0±1.8	0.01
Open fracture, n (%)	5 (10.6)	12 (29.2)	<0.05
Hemoglobin (g/dL)	11.4±0.3	11.3±0.3	n.s.
Creatinine phosphokinesis (IU/L)	579.3±69.9	675.0±224.1	n.s.
Prothrombin time (%)	78.2±3.6	91.0±3.1	0.01
FDP (μg/mL)	347.7±63.5	34.9±4.3	<0.0001
Transfusion (U)	13.6±1.7	7.5±1.1	<0.01
Mortality rate, n (%)	10 (21.2)	2 (4.8)	<0.05

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