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ID 59911
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Author
Yumoto Tetsuya Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Ihoriya, Hiromi Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Tanabe, Ryo Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences
Naitou, Hiromichi Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences ORCID Kaken ID publons
Nakao, Atsunori Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kaken ID
Abstract
Objective
Several scoring systems have been developed to identify patients who require massive transfusion (MT) after major trauma to improve survival. The primary goal of this study was to investigate the usefulness of enhanced computed tomography attenuation values (CTAVs) of major vessels to determine the need for MT in patients with major blunt trauma.
Methods
This single-center retrospective cohort study evaluated patients aged 16 years or older who underwent contrast-enhanced computed tomography scan of the torso after major blunt trauma. The CTAVs of six major vessel points in both the arterial and portal venous phases at initial computed tomography examination were assessed and compared between the MT and the no MT group. The capability of enhanced CTAVs to predict the necessity for MT was estimated based on the area under the receiver operating characteristic curve.
Results
Of the 254 eligible patients, 36 (14%) were in the MT group. Patients in the MT group had significantly higher CTAVs at all sites except the inferior vena cava in both the arterial and portal venous phases than that in the no MT group. The descending aorta in the arterial phase had the highest accuracy for predicting MT, with an AUROC of 0.901 (95% confidence interval, 0.855 to 0.947; P<0.001).
Conclusion
Initial elevation of enhanced CTAV of the aorta is a predictor for the need for MT. A higher CTAV of the aorta should alert the trauma surgeon or emergency physician to activate their MT protocol.
Keywords
Computed tomography attenuated value
Massive transfusion
Wounds and injuries
Published Date
2019-12-31
Publication Title
Clinical and Experimental Emergency Medicine
Volume
volume6
Issue
issue4
Publisher
The Korean Society of Emergency Medicine
Start Page
330
End Page
339
ISSN
2383-4625
Content Type
Journal Article
language
英語
OAI-PMH Set
岡山大学
Copyright Holders
Copyright © 2019 The Korean Society of Emergency Medicine
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publisher
PubMed ID
DOI
Web of Science KeyUT
Related Url
isVersionOf https://doi.org/10.15441/ceem.18.090
License
http://creativecommons.org/licenses/by-nc/4.0/