Abstract
Background
Injury severity score, serum lactate, and shock index help the physician determine
the severity of injuries present and have been shown to relate to mortality. We sought
to determine if an increasing amount of packed red blood cells (PRBCs) given in the
first 24 hours of admission is an independent predictor of mortality and how it compares to
other validated markers.
Methods
A 6-year retrospective, observational study of adult trauma patients was conducted
at a level 1 trauma center. Charts were reviewed for demographic data, amount of PRBC
received in the first 24 hours, injury severity score, shock index, and lactate levels. Subgroups were used
to determine if each variable was an independent predictor of mortality. Correlation
coefficients and linear regression were used to determine the strength of correlation
between each variable and mortality.
Results
One hundred fifty-seven patients met criteria over a 6-year period. The average age
was 28 years, 93% were male, and 86% had penetrating injuries. The average injury severity
score, serum lactate, and shock index were 18, 6.1, and 0.9, respectively. The average
amount of blood given was 6.7 U.
Conclusion
Twenty-four-hour PRBC requirement is both a novel independent predictor of and has
the greatest correlation to mortality in adult trauma patients when compared to injury
severity score, shock index, and serum lactate.
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Article Info
Publication History
Published online: March 17, 2016
Accepted:
March 14,
2016
Received in revised form:
March 10,
2016
Received:
November 20,
2015
Footnotes
There are no conflict of interest or funding support to report.
This study was presented at 2015 American College of Emergency Physicians national conference in Boston, MA.
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
