| Title |
How useful are hemoglobin concentration and its variations to predict significant hemorrhage in the early phase of trauma? A multicentric cohort study
|
|---|---|
| Published in |
Annals of Intensive Care, July 2018
|
| DOI | 10.1186/s13613-018-0420-8 |
| Pubmed ID | |
| Authors |
S. Figueiredo, C. Taconet, A. Harrois, S. Hamada, T. Gauss, M. Raux, J. Duranteau, the Traumabase Group |
| Abstract |
The diagnostic value of hemoglobin (Hb) for detecting a significant hemorrhage (SH) in the early phase of trauma remains controversial. The present study aimed to assess the abilities of Hb measurements taken at different times throughout trauma management to identify patients with SH. All consecutive adult trauma patients directly admitted to six French level-1 trauma centers with at least one prehospital Hb measurement were analyzed. The abilities of the following variables to identify SH (≥ 4 units of red blood cells in the first 6 h and/or death related to uncontrolled bleeding within 24 h) were determined and compared to that of shock index (SI): Hb as measured with a point-of-care (POC) device by the prehospital team on scene (POC-Hbprehosp) and upon patient's admission to the hospital (POC-Hbhosp), the difference between POC-Hbhosp and POC-Hbprehosp (DeltaPOC-Hb) and Hb as measured by the hospital laboratory on admission (Hb-Labhosp). A total of 6402 patients were included, 755 with SH and 5647 controls (CL). POC-Hbprehosp significantly predicted SH with an area under ROC curve (AUC) of 0.72 and best cutoff values of 12 g/dl for women and 13 g/dl for men. POC-Hbprehosp < 12 g/dl had 90% specificity to predict of SH. POC-Hbhosp and Hb-Labhosp (AUCs of 0.92 and 0.89, respectively) predicted SH better than SI (AUC = 0.77, p < 0.001); best cutoff values of POC-Hbhosp were 10 g/dl for women and 12 g/dl for men. DeltaPOC-Hb also predicted SH with an AUC of 0.77, a best cutoff value of - 2 g/dl irrespective of the gender. For a same prehospital fluid volume infused, DeltaPOC-Hb was significantly larger in patients with significant hemorrhage than in controls. Challenging the classical idea that early Hb measurement is not meaningful in predicting SH, POC-Hbprehosp was able, albeit modestly, to predict significant hemorrhage. POC-Hbhosp had a greater ability to predict SH when compared to shock index. For a given prehospital fluid volume infused, the magnitude of the Hb drop was significantly higher in patients with significant hemorrhage than in controls. |
X Demographics
The data shown below were collected from the profiles of 16 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 5 | 31% |
| Spain | 2 | 13% |
| Australia | 1 | 6% |
| Algeria | 1 | 6% |
| France | 1 | 6% |
| Unknown | 6 | 38% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 13 | 81% |
| Practitioners (doctors, other healthcare professionals) | 3 | 19% |
Mendeley readers
The data shown below were compiled from readership statistics for 61 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 61 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 9 | 15% |
| Student > Master | 8 | 13% |
| Researcher | 6 | 10% |
| Student > Bachelor | 5 | 8% |
| Student > Doctoral Student | 4 | 7% |
| Other | 13 | 21% |
| Unknown | 16 | 26% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 30 | 49% |
| Nursing and Health Professions | 4 | 7% |
| Agricultural and Biological Sciences | 3 | 5% |
| Environmental Science | 2 | 3% |
| Unspecified | 1 | 2% |
| Other | 3 | 5% |
| Unknown | 18 | 30% |
Attention Score in Context
This research output has an Altmetric Attention Score of 12. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 18 February 2024.
All research outputs
#3,070,926
of 25,388,229 outputs
Outputs from Annals of Intensive Care
#409
of 1,190 outputs
Outputs of similar age
#58,092
of 334,691 outputs
Outputs of similar age from Annals of Intensive Care
#5
of 16 outputs
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