Snyder H S
Department of Emergency Medicine, Albany Medical College, NY 12208, USA.
Am J Emerg Med. 1998 Mar;16(2):150-3. doi: 10.1016/s0735-6757(98)90033-x.
This study was designed to determine whether the initial spun hematocrit (HCT) value correlated with blood loss requiring operative intervention (OR). A spun HCT was performed on the first available blood sample from 524 admitted patients 12 years of age or older with traumatic injuries (86% blunt, 14% penetrating). Patients in the OR (n = 66) group had a lower mean HCT (35 v 41, P < .001) when compared with the non-OR group. The 81 patients with an HCT of < or = 35 required OR more frequently (41% v 7%, P < .001). An HCT of < or = 35 had a sensitivity of 50%, specificity of 90%, positive predictive value of 41%, and negative predictive value of 93% for identifying the OR group. The effect of hemodilution from intravenous fluid is difficult to assess in a retrospective clinical study.
本研究旨在确定初始旋转血细胞比容(HCT)值是否与需要手术干预(OR)的失血量相关。对524例12岁及以上因创伤入院的患者(86%为钝性伤,14%为穿透伤)的首份可用血样进行旋转HCT检测。与非手术干预组相比,手术干预组(n = 66)患者的平均HCT较低(35比41,P <.001)。81例HCT≤35的患者更频繁地需要手术干预(41%比7%,P <.001)。HCT≤35对于识别手术干预组的敏感性为50%,特异性为90%,阳性预测值为41%,阴性预测值为93%。在回顾性临床研究中,很难评估静脉输液引起的血液稀释的影响。