Utility of admission chemistry and coagulation profiles in trauma patients: a reappraisal of traditional practice.
To determine whether abnormal results of admission serum chemistry profiles (P7: sodium (Na), potassium (K), chloride (Cl), carbon dioxide content (CO2), blood urea nitrogen (BUN), creatinine (Cr), and glucose (GLU), amylase (AMY), and coagulation profiles (CP: prothrombin time (PT) and partial thromboplastin time (PTT) in trauma patients lead to clinical interventions, and to characterize frequency of abnormal results, we prospectively gathered laboratory data on 500 consecutive patients seen in our Level 1 trauma center. Clinicians were blinded to the study. Abnormal results were found in 93% of P7s, 7% of AMYs, and 59% of CPs. Interventions were made for < 1% of abnormal P7s, 0% of abnormal amylase, and 5% of patients with abnormal CP. We conclude that information provided by routine admission chemistry and coagulation profiles in trauma patients seldom lead to clinical interventions. These tests should not be ordered routinely on admission in trauma patients.
Namias
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Department of Surgery, University of Miami/Jackson Memorial Medical Center, FL, USA.
McKenney
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Martin
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LC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001774:Blood Chemical Analysis / Q000706:statistics & numerical data*; D001780:Blood Coagulation Tests / Q000706:statistics & numerical data*; D002648:Child; D002675:Child, Preschool; D003955:Diagnostic Tests, Routine / Q000191:economics / Q000706:statistics & numerical data*; D005260:Female; D005431:Florida; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010343:Patient Admission; D014193:Trauma Centers; D014947:Wounds and Injuries / Q000097:blood* / Q000503:physiopathology