| Hemoperitoneum semiquantitative analysis on admission of blunt trauma patients improves the prediction of massive transfusion. | |
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MedLine Citation:
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PMID: 22980362 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: The purpose of this study was to define whether the semiquantitative analysis of hemoperitoneum increases the accuracy of early prediction of massive transfusion (MT). METHODS: A retrospective review of severe trauma patients consecutively admitted to our trauma intensive care unit between January 2005 and December 2009 was conducted. Patients diagnosed with blunt abdominal trauma who had a computed tomography scan on admission were included. The hemoperitoneum size was defined using the Federle score on computed tomography as large, moderate, or minimal/none. The association between MT (≥10 U of packed red blood cells in the first 24 h) and moderate and large sizes of hemoperitoneum was assessed using a multiple logistic model. RESULTS: Of the 381 patients meeting the inclusion criteria, 270 (71%) were male; the mean age was 35.5 ± 18.2 years and mean injury severity score was 23.4 ± 17. Ninety-seven (26%) had large hemoperitoneum, 107 (28%) had moderate hemoperitoneum, and 177 (46%) had minimal/no hemoperitoneum. Eighty-three patients (22%) required MT. The positive predictive value for MT of a large hemoperitoneum was 41%, 23% for a moderate hemoperitoneum, and 10% for minimal/no hemoperitoneum (P < .001). The corresponding values for hypotensive patients were 61%, 32%, and 25%, respectively (P < .001). In the multivariate analysis model, only the large size of hemoperitoneum was significantly associated with MT (OR 6.4, 95% CI 2.9-14, P < .001, r(2) = 0.47). CONCLUSION: The assessment of the size of hemoperitoneum on admission substantially improves the prediction of MT in trauma patients and should be used to trigger and guide initial haemostatic resuscitation. |
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Authors:
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Jonathan Charbit; Martin Mahul; Jean-Paul Roustan; Pascal Latry; Ingrid Millet; Patrice Taourel; Xavier Capdevila |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-9-11 |
Journal Detail:
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Title: The American journal of emergency medicine Volume: - ISSN: 1532-8171 ISO Abbreviation: Am J Emerg Med Publication Date: 2012 Sep |
Date Detail:
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Created Date: 2012-9-17 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8309942 Medline TA: Am J Emerg Med Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Anesthesiology and Critical Care, Lapeyronie University Hospital, Montpellier, F-34295 Cedex 5, France. Electronic address: j-charbit@chu-montpellier.fr. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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