title: FDP/fibrinogen ratio reflects the requirement of packed red blood cell transfusion in patients with blunt trauma.
abstract: OBJECTIVE
  To find factors that predict the requirement of packed red blood cells (pRBC) transfusion in patients with blunt trauma on arrival at the hospital.
  
  
  METHODS
  We conducted blood tests in trauma patients whose trauma severity was suspected as being 3 and over in the Abbreviated Injury Scale. Patients were divided into the blood transfusion (BT) and control groups according to the requirement of pRBC transfusion within 24h after arrival.
  
  
  RESULTS
  We analyzed 347 patients (BT group, n=14; control group, n=333). On univariate analysis, there were significant differences in Glasgow Coma Scale (GCS), rate of positive FAST (focused assessment with sonography for trauma) finding, hematocrit, international normalized ratio of prothrombin time, activated partial thromboplastin time, fibrinogen (Fib), and level of fibrin degradation products (FDP). On multivariable analysis, positive FAST finding, GCS, Fib, and FDP influenced the requirement of pRBC transfusion. In the area under the receiver operating characteristic curve analysis, Fib and FDP were markers that predicted the requirement of pRBC transfusion. The FDP/Fib ratio had a better correlation with the requirement of pRBC transfusion than FDP or Fib.
  
  
  CONCLUSIONS
  The FDP/Fib ratio can be easily measured and may be a predictor of the need for pRBC transfusion.
authors.affiliation: Department of Emergency Medicine, Gunma University Graduate School of Medicine, Japan; Emergency Medical Care Center, Gunma University Hospital, Japan. Electronic address: shuhagiwara@gunma-u.ac.jp.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Hagiwara
authors.affiliation: Department of Emergency Medicine, Gunma University Graduate School of Medicine, Japan; Emergency Medical Care Center, Gunma University Hospital, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Aoki
authors.affiliation: Department of Emergency Medicine, Gunma University Graduate School of Medicine, Japan; Emergency Medical Care Center, Gunma University Hospital, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Murata
authors.affiliation: Department of Emergency Medicine, Gunma University Graduate School of Medicine, Japan; Emergency Medical Care Center, Gunma University Hospital, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Kaneko
authors.affiliation: Department of Emergency Medicine, Gunma University Graduate School of Medicine, Japan; Emergency Medical Care Center, Gunma University Hospital, Japan.
authors.forename: Yumi
authors.initials: Y
authors.lastname: Ichikawa
authors.affiliation: Department of Emergency Medicine, Gunma University Graduate School of Medicine, Japan; Emergency Medical Care Center, Gunma University Hospital, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Nakajima
authors.affiliation: Department of Emergency Medicine, Gunma University Graduate School of Medicine, Japan; Emergency Medical Care Center, Gunma University Hospital, Japan.
authors.forename: Yuta
authors.initials: Y
authors.lastname: Isshiki
authors.affiliation: Department of Emergency Medicine, Gunma University Graduate School of Medicine, Japan; Emergency Medical Care Center, Gunma University Hospital, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Sawada
authors.affiliation: Department of General Medicine, Gunma University Graduate School of Medicine, Japan; Emergency Medical Care Center, Gunma University Hospital, Japan.
authors.forename: Jun'ichi
authors.initials: J
authors.lastname: Tamura
authors.affiliation: Department of Emergency Medicine, Gunma University Graduate School of Medicine, Japan; Emergency Medical Care Center, Gunma University Hospital, Japan.
authors.forename: Kiyohiro
authors.initials: K
authors.lastname: Oshima
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000378:metabolism; D017707:Erythrocyte Transfusion / Q000379:methods; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism / Q000627:therapeutic use*; D005340:Fibrinogen / Q000378:metabolism*; D015600:Glasgow Coma Scale; D006801:Humans; D015601:Injury Severity Score; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D010314:Partial Thromboplastin Time; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D014193:Trauma Centers; D014949:Wounds, Nonpenetrating / Q000378:metabolism / Q000503:physiopathology / Q000628:therapy*
chemical_list: D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; C036309:fibrin fragment D; D005340:Fibrinogen
keywords: Blood transfusion; Blunt trauma; Coagulation marker; Emergency department