| Serial hematocrit testing does not identify major injuries in trauma patients in an observation unit. | |
MedLine Citation:
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PMID: 20466228 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Routine serial hematocrit measurements are a component of the trauma evaluation for patients without serious injury identified on initial evaluation. We sought to determine whether serial hematocrit testing was useful in detecting significant intra-abdominal injuries in trauma patients in our observation unit. METHODS: We performed a retrospective chart review of all trauma patients placed in our observation unit over a 14-month period. Patients had received trauma surgery evaluation before placement in the observation unit and routinely received serial hematocrit testing (>or=2 hematocrit levels) while in the observation unit. We compared trauma patients with a hematocrit drop of 5 points or more to those without a significant hematocrit drop. RESULTS: Three hundred sixty-five trauma patients were placed in the observation unit, and 310 patients (85%) had at least 2 hematocrits drawn during their stay. Of these patients, 20.6% had a hematocrit drop of 5 or more. Of patients with the hematocrit change, 18.8% were admitted to an inpatient unit from the observation unit compared to 9.3% of patients without a significant hematocrit change (P = .034). In one of these patients who had a computed tomography scan before observation admission, which demonstrated free fluid, the hematocrit drop assisted in diagnosing significant intra-abdominal injury. CONCLUSION: Although serial hematocrit testing may be useful in specific situations, routine use of serial hematocrit testing in trauma patients at a level I trauma center's observation unit did not significantly aid in the detection of occult injury. |
Authors:
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Troy Madsen; Matthew Dawson; Joseph Bledsoe; Philip Bossart |
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Publication Detail:
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Type: Journal Article Date: 2010-01-28 |
Journal Detail:
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Title: The American journal of emergency medicine Volume: 28 ISSN: 1532-8171 ISO Abbreviation: Am J Emerg Med Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-05-14 Completed Date: 2010-06-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8309942 Medline TA: Am J Emerg Med Country: United States |
Other Details:
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Languages: eng Pagination: 472-6 Citation Subset: IM |
Copyright Information:
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(c) 2010 Elsevier Inc. All rights reserved. |
Affiliation:
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Division of Emergency Medicine, University of Utah, Salt Lake City, UT 84132, USA. troy.madsen@hsc.utah.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Abdominal Injuries
/
blood,
diagnosis* Adult Confidence Intervals Emergency Service, Hospital Female Hematocrit* Humans Male Monitoring, Physiologic Odds Ratio Retrospective Studies Time Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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