title: Fibrinogen and base excess levels as predictive markers of the need for massive blood transfusion after blunt trauma.
abstract: BACKGROUND
  Assessment blood consumption and trauma-associated severe hemorrhage scores are useful for predicting the need for massive transfusion (MT) in severe trauma patients. However, fibrinogen (Fbg) and base excess (BE) levels might also be useful indicators for the need for MT. We evaluated the accuracy of prediction for MT of the scoring system vs. Fbg and BE.
  
  
  METHODS
  The subjects of this retrospective single center observational study were patients with injury severity score ≥16 trauma, divided into a non-MT group and an MT group. We compared variables, including the scoring system (comprising vital signs and focused assessment with sonography for trauma; FAST) and Fbg between the groups. We then performed a multiple logistic regression modeling and a receiver operating characteristic analysis to clarify which value was the most useful predictive indicator for MT.
  
  
  RESULTS
  There were 114 patients in the non-MT group and 39 in the MT group. The level of Fbg and BE were independent predictors of MT. The area under the curve values for Fbg and BE were 0.765 and 0.845, respectively, and the optimal cutoff values of Fbg and BE were 211 mg/dL and -1.4, respectively.
  
  
  CONCLUSIONS
  Fbg and BE levels can be used as an independent predictor for MT.
authors.affiliation: Department of Emergency and Critical Care Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonanku, Fukuoka, 814-0180, Japan.
authors.forename: Takehiro
authors.initials: T
authors.lastname: Umemura
authors.affiliation: Department of Emergency and Critical Care Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonanku, Fukuoka, 814-0180, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Nakamura
authors.affiliation: Department of Emergency and Critical Care Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonanku, Fukuoka, 814-0180, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nishida
authors.affiliation: Department of Emergency and Critical Care Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonanku, Fukuoka, 814-0180, Japan.
authors.forename: Kota
authors.initials: K
authors.lastname: Hoshino
authors.affiliation: Department of Emergency and Critical Care Medicine, Faculty of Medicine, Fukuoka University, 7-45-1 Nanakuma, Jonanku, Fukuoka, 814-0180, Japan. ishikurah@fukuoka-u.ac.jp.
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Ishikura
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001803:Blood Transfusion; D005260:Female; D005340:Fibrinogen / Q000032:analysis*; D006470:Hemorrhage / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D006801:Humans; D007773:Lactates / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D015599:Trauma Severity Indices; D014949:Wounds, Nonpenetrating / Q000150:complications*
chemical_list: D015415:Biomarkers; D007773:Lactates; D005340:Fibrinogen
keywords: Blunt trauma patients; Fibrinogen level; Massive transfusion; Scoring system