Yanagawa Youichi, Ishikawa Kouhei, Jitsuiki Kei, Yoshizawa Toshihiko, Oode Yasumasa, Omori Kazuhiko, Ohsaka Hiromichi
Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University, Nagaoka Izunokuni City Shizuoka, Japan.
World J Emerg Med. 2017;8(2):106-109. doi: 10.5847/wjem.j.1920-8642.2017.02.004.
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.
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.
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 (=0.35, =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.
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.
关于有无头部损伤的创伤患者中纤维蛋白原降解产物(FDP)水平的临床意义,相关报道较少。我们回顾性分析了有无头部损伤的创伤患者,以探讨FDP水平的临床意义。
2013年4月至2015年6月,对所有创伤患者进行回顾性病历审查。排除标准包括未接受输血的患者。患者分为两组:FDP>100组,包括入院时FDP水平超过100 ng/mL的患者;FDP≤100组。
FDP>100组的开放性骨折比例和凝血酶原比值显著低于FDP≤100组。FDP>100组的平均年龄、钝性损伤比例、损伤严重程度评分(ISS)、输血量和死亡率显著高于FDP≤100组。FDP水平与ISS之间存在弱正相关(=0.35,=0.002),但与输血量无关。排除头部损伤患者后的分析结果显示出类似趋势。
即使在无头部损伤或生命体征稳定的钝性创伤患者中,FDP水平也可能是创伤严重程度和死亡率初始评估的有用生化参数。