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The Addition of ROTEM Parameter Did Not Significantly Improve the Massive Transfusion Prediction in Severe Trauma Patients

BACKGROUND: Rotational thrombelastometry (ROTEM) has been used to evaluate the coagulation state, predict transfusion, and optimize hemostatic management in trauma patients. However, there were limited studies on whether the prediction value could be improved by adding the ROTEM parameter to the pre...

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Autores principales: Baik, Dongyup, Yeom, Seok-Ran, Park, Sung-Wook, Cho, Youngmo, Yang, Wook Tae, Kwon, Hoon, Lee, Jae Il, Ko, Jun-Kyeung, Choi, Hyuk Jin, Huh, Up, Goh, Tae Sik, Song, Chan-Hee, Hwangbo, Lee, Wang, Il Jae
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9588372/
https://www.ncbi.nlm.nih.gov/pubmed/36285178
http://dx.doi.org/10.1155/2022/7219812
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author Baik, Dongyup
Yeom, Seok-Ran
Park, Sung-Wook
Cho, Youngmo
Yang, Wook Tae
Kwon, Hoon
Lee, Jae Il
Ko, Jun-Kyeung
Choi, Hyuk Jin
Huh, Up
Goh, Tae Sik
Song, Chan-Hee
Hwangbo, Lee
Wang, Il Jae
author_facet Baik, Dongyup
Yeom, Seok-Ran
Park, Sung-Wook
Cho, Youngmo
Yang, Wook Tae
Kwon, Hoon
Lee, Jae Il
Ko, Jun-Kyeung
Choi, Hyuk Jin
Huh, Up
Goh, Tae Sik
Song, Chan-Hee
Hwangbo, Lee
Wang, Il Jae
author_sort Baik, Dongyup
collection PubMed
description BACKGROUND: Rotational thrombelastometry (ROTEM) has been used to evaluate the coagulation state, predict transfusion, and optimize hemostatic management in trauma patients. However, there were limited studies on whether the prediction value could be improved by adding the ROTEM parameter to the prediction model for in-hospital mortality and massive transfusion (MT) in trauma patients. OBJECTIVE: This study assessed whether ROTEM data could improve the MT prediction model. METHOD: This was a single-center, retrospective study. Patients who presented to the trauma center and underwent ROTEM between 2016 and 2020 were included. The primary and secondary outcomes were massive transfusions and in-hospital mortality, respectively. We constructed two models using multivariate logistic regression with backward conditional stepwise elimination (Model 1: without the ROTEM parameter and Model 2: with the ROTEM parameter). The area under the receiver operating characteristic curve (AUROC) was calculated to assess the predictive ability of the models. RESULT: In total, 969 patients were included; 196 (20.2%) received MT. The in-hospital mortality rate was 14.1%. For MT, the AUROC was 0.854 (95% confidence interval [CI], 0.825–0.883) and 0.860 (95% CI, 0.832–0.888) for Model 1 and 2, respectively. For in-hospital mortality, the AUROC was 0.886 (95% CI, 0.857–0.915) and 0.889 (95% CI, 0.861–0.918) for models 1 and 2, respectively. The AUROC values for models 1 and 2 were not statistically different for either MT or in-hospital mortality. CONCLUSION: We found that the addition of the ROTEM parameter did not significantly improve the predictive power of MT and in-hospital mortality in trauma patients.
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spelling pubmed-95883722022-10-24 The Addition of ROTEM Parameter Did Not Significantly Improve the Massive Transfusion Prediction in Severe Trauma Patients Baik, Dongyup Yeom, Seok-Ran Park, Sung-Wook Cho, Youngmo Yang, Wook Tae Kwon, Hoon Lee, Jae Il Ko, Jun-Kyeung Choi, Hyuk Jin Huh, Up Goh, Tae Sik Song, Chan-Hee Hwangbo, Lee Wang, Il Jae Emerg Med Int Research Article BACKGROUND: Rotational thrombelastometry (ROTEM) has been used to evaluate the coagulation state, predict transfusion, and optimize hemostatic management in trauma patients. However, there were limited studies on whether the prediction value could be improved by adding the ROTEM parameter to the prediction model for in-hospital mortality and massive transfusion (MT) in trauma patients. OBJECTIVE: This study assessed whether ROTEM data could improve the MT prediction model. METHOD: This was a single-center, retrospective study. Patients who presented to the trauma center and underwent ROTEM between 2016 and 2020 were included. The primary and secondary outcomes were massive transfusions and in-hospital mortality, respectively. We constructed two models using multivariate logistic regression with backward conditional stepwise elimination (Model 1: without the ROTEM parameter and Model 2: with the ROTEM parameter). The area under the receiver operating characteristic curve (AUROC) was calculated to assess the predictive ability of the models. RESULT: In total, 969 patients were included; 196 (20.2%) received MT. The in-hospital mortality rate was 14.1%. For MT, the AUROC was 0.854 (95% confidence interval [CI], 0.825–0.883) and 0.860 (95% CI, 0.832–0.888) for Model 1 and 2, respectively. For in-hospital mortality, the AUROC was 0.886 (95% CI, 0.857–0.915) and 0.889 (95% CI, 0.861–0.918) for models 1 and 2, respectively. The AUROC values for models 1 and 2 were not statistically different for either MT or in-hospital mortality. CONCLUSION: We found that the addition of the ROTEM parameter did not significantly improve the predictive power of MT and in-hospital mortality in trauma patients. Hindawi 2022-10-15 /pmc/articles/PMC9588372/ /pubmed/36285178 http://dx.doi.org/10.1155/2022/7219812 Text en Copyright © 2022 Dongyup Baik et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Baik, Dongyup
Yeom, Seok-Ran
Park, Sung-Wook
Cho, Youngmo
Yang, Wook Tae
Kwon, Hoon
Lee, Jae Il
Ko, Jun-Kyeung
Choi, Hyuk Jin
Huh, Up
Goh, Tae Sik
Song, Chan-Hee
Hwangbo, Lee
Wang, Il Jae
The Addition of ROTEM Parameter Did Not Significantly Improve the Massive Transfusion Prediction in Severe Trauma Patients
title The Addition of ROTEM Parameter Did Not Significantly Improve the Massive Transfusion Prediction in Severe Trauma Patients
title_full The Addition of ROTEM Parameter Did Not Significantly Improve the Massive Transfusion Prediction in Severe Trauma Patients
title_fullStr The Addition of ROTEM Parameter Did Not Significantly Improve the Massive Transfusion Prediction in Severe Trauma Patients
title_full_unstemmed The Addition of ROTEM Parameter Did Not Significantly Improve the Massive Transfusion Prediction in Severe Trauma Patients
title_short The Addition of ROTEM Parameter Did Not Significantly Improve the Massive Transfusion Prediction in Severe Trauma Patients
title_sort addition of rotem parameter did not significantly improve the massive transfusion prediction in severe trauma patients
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9588372/
https://www.ncbi.nlm.nih.gov/pubmed/36285178
http://dx.doi.org/10.1155/2022/7219812
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