Navigation Links
Early predictive model may be new 'weapon' against leading cause of death on battlefield
Date:10/24/2007

CHICAGO (October 24, 2007) -- Combat physicians in war-torn areas like Iraq and Afghanistan may be able to accurately predict which casualties require massive blood transfusions (MT), and thereby increase a soldier's chances of survival, according to research published in the October issue of The Journal of the American College of Surgeons. The study found that the presence of a combination of three variables -- assessed immediately upon arrival at the combat support hospital -- is highly predictive of which soldiers will need MT, thus allowing physicians to mobilize the necessary resources to transfuse large amounts of blood. The three variables are hemoglobin 11g/dL, International Normalized Ratio > 1.5, and a penetrating injury mechanism such as those caused by improvised explosive devices (IEDs) or high-powered weapons.

Hemorrhage (blood loss) is the leading cause of death on the battlefield. Severely injured patients require MT to restore adequate delivery of oxygen to the body. "The sooner we know that a solider needs a massive blood transfusion, the better," said Martin A. Schreiber, MD, FACS, chief of trauma at Oregon Health & Science University, Portland. "Since we have limited access to blood products in combat hospitals and we rely heavily on walking blood banks, it is crucial to be able to mobilize these precious resources early after patients are injured."

Identifying donors and then testing their blood for viruses like hepatitis C and HIV can take up to one hour, a critical period of time in a severely injured patient.

This retrospective cohort analysis included 558 combat victims treated at two combat support hospitals in Iraq. Patients who required MT (n=247), defined as delivery of 10 units of a combination of stored red blood cells and fresh whole blood in the first 24 hours after injury, were compared with patients who did not (n=311). Potentially predictive variables studied were age, gender, mechanism of injury, International Normalized Ratio (INR, the ratio of a patient's prothrombin time to a normal, or control, sample that is used to determine the blood's tendency to clot), prothrombin time, partial thromboplastin time, hemoglobin level and platelet count.

Based on a stepwise logistic regression analysis, a hemoglobin level 11 grams/deciliter (g/dL), INR >1.5 and a penetrating injury mechanism (e.g., injuries resulting from improvised explosive devices (IEDs) and high-powered weapons), were found to be independently predictive of the need for MT. The single most predictive variable was a hemoglobin level 11 g/dL, with an odds ratio of 7.7. Researchers determined that a combination of these three variables reliably predicts the need for MT.

Dr. Schreiber added that this work is a unique addition to the literature on predictors of MT because the study population consisted primarily of young male patients with injuries sustained by IEDs and high-powered weapons, which is quite different from a typical civilian population. Despite these facts, mortality in the MT group was identical to the mortality reported by a recently published study from a large civilian center.

Researchers also found that coagulopathy (a defect in the body's blood clotting process) occurs early after injury in severely injured combat victims and is associated with the need for MT and high mortality. Mortality was 39 percent in the MT group and 1 percent in the non-MT group (p<0.001).

The primary finding of this study is that the combination of hemoglobin 11 g/dL, INR > 1.5, and a penetrating mechanism reliably predict the need for MT. Using rapid laboratory technology, these variables are available within a few minutes of the patients' arrival, allowing the treating physicians to organize the resources necessary to deal with an MT patient. Dr. Schreiber is a Lieutenant Colonel in the Unites States Army Reserve.


'/>"/>

Contact: Sally Garneski
pressinquiry@facs.org
312-202-5409
Weber Shandwick Worldwide
Source:Eurekalert

Related medicine news :

1. Gene linked to early puberty in girls
2. Cancer drugs in development nearly doubled since 1995
3. Nearly all asthma deaths preventable
4. Ductal lavage may detect early breast cancer
5. Doctors advice early anemia tests
6. Heart disease threat starts early in life for Diabetics
7. Early detection of prostate cancer
8. Early detection of heart attack
9. Early puberty linked to nutrition
10. Exercise to Prevent Early Breast Cancer
11. Drug Found To Bring Relief For Individuals With Early Parkinson’
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:6/24/2017)... ... June 24, 2017 , ... ... Located at 217 Portion Road in Lake Ronkonkoma, Dental365 offers patients high-quality and ... so that visits to the dentist fit into their patients’ busy lifestyles. Dental365 ...
(Date:6/23/2017)... ... June 23, 2017 , ... ... the launch of Care Management Alerts and Dashboards, an innovative new service enabling ... Island. , RIQI’s Care Management Alerts and Dashboards provide near real-time data about ...
(Date:6/23/2017)... ... 2017 , ... Yesterday, U.S. Senate Republicans revealed details of ... replace the Affordable Care Act (ACA). Like the bill narrowly passed by the ... public health insurance program for low-income children, pregnant women, parents of dependent children, ...
(Date:6/23/2017)... ... 2017 , ... Dr. Ran Y. Rubinstein , a ... offering three new minimally invasive procedures to patients who want a younger and ... Rubinstein is excited to bring microneedling, microneedling facials, and platelet rich plasma (PRP) ...
(Date:6/23/2017)... ... ... Goodcents Deli Fresh Subs today announced the opening of a new restaurant in ... Kan. 66604 (near 21st and Gage). It is owned and operated by long-time Goodcents ... the Topeka and Bonner Springs, Kan. area. , “Goodcents has such a loyal ...
Breaking Medicine News(10 mins):
(Date:6/8/2017)... Fla. , June 8, 2017  Less than ... that hit more than 200,000 companies, including hospital networks, ... being heralded as one of the largest online extortion ... in the healthcare market, it is imperative that providers ... protect their data from this — and many other ...
(Date:6/7/2017)... 2017  Diplomat Specialty Infusion Group, a brand of Diplomat Pharmacy, ... Iowa location. The ... features an ISO 7 cleanroom—the standard needed to compound intravenous (IV) ... level of pollutants. "Our new ... better serve our Iowa patients," said ...
(Date:6/1/2017)... BLUE BELL, Pa. , June 1, 2017 /PRNewswire/ ... Nutriceuticals (PRN) and Veterinarian Recommended Solutions (VRS), and KD ... direct investment in Nutriceutical Holdings by KD Pharma Group. ... Nutriceutical Holdings with the option to acquire the entire ... ideal partner in KD. They are committed to growing ...
Breaking Medicine Technology: