| Title: | High D-dimer levels predict a poor outcome in patients with severe trauma, even with high fibrinogen levels on arrival : a multicenter retrospective study |
| Authors: | Hayakawa, Mineji Browse this author →KAKEN DB |
| Maekawa, Kunihiko Browse this author |
| Kushimoto, Shigeki Browse this author →KAKEN DB |
| Kato, Hiroshi Browse this author |
| Sasaki, Junichi Browse this author |
| Ogura, Hiroshi Browse this author →KAKEN DB |
| Matauoka, Tetsuya Browse this author |
| Uejima, Toshifumi Browse this author |
| Morimura, Naoto Browse this author |
| Ishikura, Hiroyasu Browse this author |
| Hagiwara, Akiyoshi Browse this author |
| Takeda, Munekazu Browse this author |
| Kaneko, Naoyuki Browse this author |
| Saitoh, Daizoh Browse this author →KAKEN DB |
| Kudo, Daisuke Browse this author →KAKEN DB |
| Kanemura, Takashi Browse this author |
| Shibusawa, Takayuki Browse this author |
| Furugori, Shintaro Browse this author |
| Nakamura, Yoshihiko Browse this author |
| Shiraishi, Atsushi Browse this author |
| Murata, Kiyoshi Browse this author |
| Mayama, Gou Browse this author |
| Yaguchi, Arino Browse this author |
| Kim, Shiei Browse this author |
| Takasu, Osamu Browse this author |
| Nishiyama, Kazutaka Browse this author |
| Keywords: | coagulopathy |
| disseminated intravascular coagulation |
| fibrinolysis |
| transfusion |
| multiple trauma |
| fibrin fibrinogen degradation products |
| Issue Date: | Mar-2016 |
| Publisher: | Lippincott Williams & Wilkins |
| Journal Title: | Shock |
| Volume: | 45 |
| Issue: | 3 |
| Start Page: | 308 |
| End Page: | 314 |
| Publisher DOI: | 10.1097/SHK.0000000000000542 |
| PMID: | 26882403 |
| Abstract: | Elevated D-dimer level in trauma patients is associated with tissue damage severity and is an indicator of hyperfibrinolysis during the early phase of trauma. To investigate the interacting effects of fibrinogen and D-dimer levels on arrival at the emergency department for massive transfusion and mortality in severe trauma patients in a multicentre retrospective study. This study included 519 adult trauma patients with an injury severity score ≥16. Patients with ≥10 units of red cell concentrate transfusion and/or death during the first 24 hours were classified as having a poor outcome. Receiver operating characteristic curve analysis for predicting poor outcome showed the optimal cut-off fibrinogen and D-dimer values to be 190 mg/dL and 38 mg/L, respectively. Based on these values, patients were divided into four groups: (1) low D-dimer (<38 mg/L)/high fibrinogen (>190 mg/dL), (2) low D-dimer (<38 mg/L)/low fibrinogen (≤190 mg/dL), (3) high D-dimer (≥38 mg/L)/high fibrinogen (>190 mg/dL), and (4) high D-dimer (≥38 mg/L)/low fibrinogen (≤190 mg/dL). The survival rate was lower in the high D-dimer/low fibrinogen group than in the other groups. Moreover, the survival rate was lower in the high D-dimer/high fibrinogen group than in the low D-dimer/high fibrinogen and low D-dimer/low fibrinogen groups. High D-dimer level on arrival is a strong predictor of early death or requirement for massive transfusion in severe trauma patients, even with high fibrinogen levels. |
| Rights: | This is a non-final version of an article published in final form in Shock, March 2016, Volume 45 Issue 3, pp. 308–314. |
| Type: | article (author version) |
| URI: | http://hdl.handle.net/2115/64634 |
| Appears in Collections: | 北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)
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