» Articles » PMID: 38558758

Association Between Lung Contusion Volume and Acute Changes in Fibrinogen Levels: A Single-center Observational Study

Overview
Journal Acute Med Surg
Specialty Critical Care
Date 2024 Apr 1
PMID 38558758
Authors
Affiliations
Soon will be listed here.
Abstract

Aim: Organ tissue damage, including the lungs, may lead to acute coagulopathy. This study aimed to evaluate the association between lung contusion volume and serum fibrinogen level during the acute phase of trauma.

Methods: We conducted an observational study using electronic medical records at a tertiary-care center between January 2015 and December 2018. We included patients with lung contusions on hospital arrival. We used three-dimensional computed tomography to calculate lung contusion volumes. The primary outcome was the lowest fibrinogen level measured within 24 h of hospital arrival. We evaluated the association between lung contusion volume and outcome with multivariable linear regression analysis. Also, we calculated the sensitivity and specificity of lung contusion volume in patients with a serum fibrinogen level of ≤150 mg/dL.

Results: We identified 124 eligible patients. Their median age was 43.5 years, and 101 were male (81.5%). The median lung contusion volume was 10.9%. The median lowest fibrinogen level within 24 h from arrival was 188.0 mg/dL. After adjustment, lung contusion volume had a statistically significant association with the lowest fibrinogen level within 24 h from arrival (coefficient -1.6, 95% confidence interval -3.16 to -0.07). When a lung contusion volume of 20% was used as the cutoff, the sensitivity and specificity to identify fibrinogen depletion were 0.27 and 0.95, respectively.

Conclusion: Lung contusion volume was associated with the lowest fibrinogen level measured within 24 h from hospital arrival. Measuring lung contusion volume may help to identify patients with a progression of fibrinogen depletion.

Citing Articles

Association between lung contusion volume and acute changes in fibrinogen levels: A single-center observational study.

Nobe R, Nakao S, Nakagawa Y, Ogura H, Shimazu T, Oda J Acute Med Surg. 2024; 11(1):e945.

PMID: 38558758 PMC: 10979042. DOI: 10.1002/ams2.945.

References
1.
Holcomb J, Jenkins D, Rhee P, Johannigman J, Mahoney P, Mehta S . Damage control resuscitation: directly addressing the early coagulopathy of trauma. J Trauma. 2007; 62(2):307-10. DOI: 10.1097/TA.0b013e3180324124. View

2.
Wang S, Ruan Z, Zhang J, Jin W . The value of pulmonary contusion volume measurement with three-dimensional computed tomography in predicting acute respiratory distress syndrome development. Ann Thorac Surg. 2011; 92(6):1977-83. DOI: 10.1016/j.athoracsur.2011.05.020. View

3.
Leone M, Albanese J, Rousseau S, Antonini F, Dubuc M, Alliez B . Pulmonary contusion in severe head trauma patients: impact on gas exchange and outcome. Chest. 2003; 124(6):2261-6. DOI: 10.1378/chest.124.6.2261. View

4.
Sugiyama K, Fujita H, Nishimura S . Effects of in-house cryoprecipitate on transfusion usage and mortality in patients with multiple trauma with severe traumatic brain injury: a retrospective cohort study. Blood Transfus. 2019; 18(1):6-12. PMC: 7053528. DOI: 10.2450/2019.0198-18. View

5.
Mahmood I, El-Menyar A, Younis B, Ahmed K, Nabir S, Ahmed M . Clinical Significance and Prognostic Implications of Quantifying Pulmonary Contusion Volume in Patients with Blunt Chest Trauma. Med Sci Monit. 2017; 23:3641-3648. PMC: 5541976. DOI: 10.12659/msm.902197. View