TY - JOUR
T1 - Akut travmada rutin laboratuvar testlerinin kullanımı
T2 - Geriye dönük bir analiz
AU - Popal, Zar
AU - Schepers, Tim
AU - van Schie, Peter
AU - Giannakopoulos, Georgios
AU - Halm, Jens
N1 - Publisher Copyright: © 2022 Turkish Association of Trauma and Emergency Surgery.
PY - 2022/7/1
Y1 - 2022/7/1
N2 - BACKGROUND: In more than 60 countries worldwide, laboratory testing plays a challenging and expensive role in trauma resus-citation. In 1995, the literature already suggested that routine laboratory testing may not be useful for most trauma patients. Our study hypothesized that still the need for some laboratory tests perhaps should be reconsidered. Therefore, the aim of this study was to create more insight in the distribution between normal and abnormal parameters for routine laboratory testing in trauma patient management. METHODS: This retrospective analysis was performed at Amsterdam UMC, location AMC, an academic level 1 trauma center. Data concerning age, gender, American Society of Anesthesiologists (ASA) physical state classification system (ASA), Injury Severity Scores, Glasgow Coma Scales, mechanism of injury, presence of high-energy trauma, and type of injury (blunt or penetrating) were obtained. Laboratory parameters included comprehensive hematology, coagulation, arterial blood gas, kidney, and liver blood panels. Analytical focus was paid to the patient's vital status, the indication for an emergency intervention, and the risk of in-hospital mortality. RESULTS: A total of 1287 patients were included in the study. Patients with unstable vital signs or who required emergency inter-vention were most often dealing with abnormalities in pO2, glucose, D-dimer, creatinine, and alcohol values. Mean corpuscular volume (MCV), international normalized ratio (INR), fibrinogen, and amylase were obtained in more than 80% of the patients, but in specific patient groups only abnormal in less than 9%. CONCLUSION: Trauma patients suffer mainly from abnormal values of D-dimer, pO2, glucose, creatinine, and alcohol. By contrast, MCV, INR, amylase, fibrinogen, and thrombocytes are regularly obtained as well, but only abnormal in a small amount of trauma patients. These findings suggest reconsiderations and more accuracy in the performance of laboratory testing, especially for trauma patients with stable vital signs.
AB - BACKGROUND: In more than 60 countries worldwide, laboratory testing plays a challenging and expensive role in trauma resus-citation. In 1995, the literature already suggested that routine laboratory testing may not be useful for most trauma patients. Our study hypothesized that still the need for some laboratory tests perhaps should be reconsidered. Therefore, the aim of this study was to create more insight in the distribution between normal and abnormal parameters for routine laboratory testing in trauma patient management. METHODS: This retrospective analysis was performed at Amsterdam UMC, location AMC, an academic level 1 trauma center. Data concerning age, gender, American Society of Anesthesiologists (ASA) physical state classification system (ASA), Injury Severity Scores, Glasgow Coma Scales, mechanism of injury, presence of high-energy trauma, and type of injury (blunt or penetrating) were obtained. Laboratory parameters included comprehensive hematology, coagulation, arterial blood gas, kidney, and liver blood panels. Analytical focus was paid to the patient's vital status, the indication for an emergency intervention, and the risk of in-hospital mortality. RESULTS: A total of 1287 patients were included in the study. Patients with unstable vital signs or who required emergency inter-vention were most often dealing with abnormalities in pO2, glucose, D-dimer, creatinine, and alcohol values. Mean corpuscular volume (MCV), international normalized ratio (INR), fibrinogen, and amylase were obtained in more than 80% of the patients, but in specific patient groups only abnormal in less than 9%. CONCLUSION: Trauma patients suffer mainly from abnormal values of D-dimer, pO2, glucose, creatinine, and alcohol. By contrast, MCV, INR, amylase, fibrinogen, and thrombocytes are regularly obtained as well, but only abnormal in a small amount of trauma patients. These findings suggest reconsiderations and more accuracy in the performance of laboratory testing, especially for trauma patients with stable vital signs.
KW - Emergency care
KW - routine laboratory testing
KW - trauma patients
KW - traumatic injury
UR - http://www.scopus.com/inward/record.url?scp=85133246159&partnerID=8YFLogxK
U2 - https://doi.org/10.14744/tjtes.2021.14826
DO - https://doi.org/10.14744/tjtes.2021.14826
M3 - Article
C2 - 35775666
SN - 1306-696X
VL - 28
SP - 954
EP - 959
JO - Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES
JF - Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES
IS - 7
ER -