title: Albumin and fibrinogen levels' relation with orthopedics traumatic patients' outcome after massive transfusion.
abstract: BACKGROUND
  Severe bleeding is common during limb trauma. It can lead to hemorrhagic shock required to massive blood transfusion. Coagulopathy is the major complication of massive transfusion-induced increased mortality rate. Aim of this study was evaluation of fibrinogen and albumin levels association with orthopedics traumatic patients' outcome who received massive transfusion.
  
  
  METHODS
  In a cross sectional study, 23 patients with severe limb injury admitted to orthopedic emergency department were studied. All the patients received massive transfusion, that is, >10 unit blood. Albumin and fibrinogen levels are measured at admission and 24 h later, and compared according to final outcome.
  
  
  RESULTS
  Twenty-three traumatic patients with severe limb injuries were studied, out of which ten (43.2%) died and 13 (56.8%) were alive. There was significant difference between patients outcome in fibrinogen level after 24 h, but no difference was observed in albumin levels. Based on regression model, fibrinogen after 24 h had a significant role in determining the final outcome in traumatic patients who received massive transfusion (odds ratio 0.48, 95% confidence interval 0.15-0.92, P = 0.02).
  
  
  CONCLUSIONS
  According to our results, fibrinogen level is the most important factor in determination of orthopedics traumatic patients when received massive transfusion. However, serum albumin does not play any role in patients' outcome.
authors.affiliation: Department of Orthopedics Surgery, Shohada Educational Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Mohammadreza
authors.initials: M
authors.lastname: Bazavar
authors.affiliation: Department of Orthopedics Surgery, Shohada Educational Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Tabrizi
authors.affiliation: Department of Anesthesia, Shohada Educational Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Naghi
authors.initials: N
authors.lastname: Abedini
authors.affiliation: Department of Orthopedics Surgery, Shohada Educational Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Asghar
authors.initials: A
authors.lastname: Elmi
keywords: Albumin; coagulopathy; fibrinogen; massive blood transfusion