Fish Eric J, Hansen Sonya C, Spangler Elizabeth A, Gaillard Philippe R, Fan Shirley, Bacek Lenore M
Department of Pathobiology, College of Science and Mathematics, Auburn University, Auburn, AL.
Department of Clinical Sciences, College of Science and Mathematics, Auburn University, Auburn, AL.
J Vet Emerg Crit Care (San Antonio). 2019 Sep;29(5):521-527. doi: 10.1111/vec.12886. Epub 2019 Sep 3.
To compare the prognostic value of admission hematologic parameters serum/plasma iron, red blood cell distribution width (RDW), and nucleated red blood cells (nRBCs) in dogs presenting with acute traumatic injury.
Retrospective observational study (2009-2015).
University teaching hospital.
One hundred and twenty-nine clinical dogs presenting within 24 hours of acute traumatic injury.
None.
One hundred and twenty-nine dogs met the inclusion criteria and 109 (84.5%) survived, while 20 (15.5%) died or were euthanized in hospital. Patients with blunt force trauma comprised 79.8% of the patient population; dogs with penetrating trauma comprised 20.2% of cases. Hypoferremia occurred in all nonsurvivors, and the median serum/plasma iron concentration was significantly lower in nonsurvivors than survivors (P = 0.028). Normal or increased serum/plasma iron had 100% specificity and 100% positive predictive value for survival. Red blood cell distribution width was not significantly different between groups (P = 0.417). The presence of nRBCs was significantly associated with nonsurvival (P = 0.030), although the absolute nRBC concentrations were not significantly different (P = 0.070). A multiple logistic regression model found age, type of injury, presence of nRBCs, and serum/plasma iron to be independent predictors of survival with an area under the receiver operator characteristic curve of 0.813.
The presence of nRBCs and low serum/plasma iron are associated with mortality in patients with acute trauma; however, red blood cell distribution width was not associated with survival. Absence of hypoferremia was highly associated with a favorable prognosis in this patient population. These parameters may warrant inclusion in trauma scoring systems.
比较急性创伤性损伤犬入院时血液学参数血清/血浆铁、红细胞分布宽度(RDW)和有核红细胞(nRBCs)的预后价值。
回顾性观察研究(2009 - 2015年)。
大学教学医院。
129只在急性创伤性损伤24小时内就诊的临床犬。
无。
129只犬符合纳入标准,109只(84.5%)存活,20只(15.5%)死亡或在医院实施安乐死。钝性创伤患者占患者总数的79.8%;穿透性创伤犬占病例的20.2%。所有非存活者均出现低铁血症,非存活者的血清/血浆铁浓度中位数显著低于存活者(P = 0.028)。血清/血浆铁正常或升高对存活的特异性为100%,阳性预测值为100%。两组间红细胞分布宽度无显著差异(P = 0.417)。有核红细胞的存在与非存活显著相关(P = 0.030),尽管有核红细胞绝对浓度无显著差异(P = 0.070)。多元逻辑回归模型发现年龄、损伤类型、有核红细胞的存在以及血清/血浆铁是存活的独立预测因素,受试者工作特征曲线下面积为0.813。
有核红细胞的存在和低血清/血浆铁与急性创伤患者的死亡率相关;然而,红细胞分布宽度与存活无关。无低铁血症与该患者群体的良好预后高度相关。这些参数可能有必要纳入创伤评分系统。