응급센터에 내원한 중증외상환자에서 평균혈소판용적의 연속 측정을 통한 다발성 장기부전 예측의 유용성
Usefulness of serial measurement of the mean platelet volume to predict multiple organ dysfunction syndrome in patients with severe trauma
양현영, 정성필, 좌민홍, 유제성, 공태영, 고동률, 황윤정, 이용희, 조영준, 박인철, 김시내,
소속 상세정보
양현영 ( Yang Hyun-Young )
Yonsei University College of Medicine Department of Emergency Medicine
정성필 ( Chung Sung-Phil )
Yonsei University College of Medicine Department of Emergency Medicine
좌민홍 ( Choa Min-Hong )
Yonsei University College of Medicine Department of Emergency Medicine
유제성 ( You Je-Sung )
Yonsei University College of Medicine Department of Emergency Medicine
공태영 ( Kong Tae-Young )
Yonsei University College of Medicine Department of Emergency Medicine
고동률 ( Ko Dong-Ryul )
Yonsei University College of Medicine Department of Emergency Medicine
황윤정 ( Hwang Yoon-Jung )
Yonsei University College of Medicine Department of Emergency Medicine
이용희 ( Lee Yong-Hee )
Yonsei University College of Medicine Department of Emergency Medicine
조영준 ( Cho Young-Joon )
Yonsei University College of Medicine Department of Emergency Medicine
박인철 ( Park In-Cheol )
Yonsei University College of Medicine Department of Emergency Medicine
김시내 ( Kim Si-Nae )
Yonsei University College of Medicine Department of Research Affairs Biostatistics Collaboration Unit
KMID : 0385920200310020169
Abstract
Objective: The early prediction of multiple organ dysfunction syndrome (MODS) in trauma patients and provision of prompt treatment may improve their outcomes. We investigated the efficacy of the mean platelet volume (MPV) for predicting MODS in cases of severe trauma.
Method: This retrospective, observational cohort study was performed with patients prospectively integrated in a critical pathway of TRAUMA. We analyzed the severe trauma patients admitted to the emergency department (ED), based on the Advanced Trauma Life Support guideline, between January 1, 2011 and May 31, 2017. The outcomes were developed from MODS at least 48 hours after ED admission.
Results: A total of 348 patients were enrolled. An increase in the MPV at 12 hours (odds ratio [OR], 2.611; P<0.001) was a strong independent predictor of MODS development. The increasing predictability of MODS was closely associated with an MPV at 12 hours>8.6 fL (OR, 4.831; P<0.001). The area under the receiver operating characteristic curve (AUROC) value of the MPV at 12 hours (0.751; 95% confidence interval [CI], 0.687-0.818; P<0.01) was not inferior than that of Acute Physiology and Chronic Health Evaluation II score, injury severity score, lactate, and total CO2 for predicting MODS.
Conclusion: MPV was an independent predictor of MODS development in severe trauma patients. Emergency physicians can use the MPV as an ancillary biomarker for predicting MODS.
키워드
Trauma; Multiple organ dysfunction syndrome; Mean platelet volume; Prognosis
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