New study finds trauma signifier

Numazu City Hospital (library image)

A new study published in the Air Medical Journal has examined the levels of fibrinogen degradation product (FDP) in trauma victims transported by air ambulances. After retrospectively charting the recorded levels from 151 patients that were flown into the Numazu City Hospital, Japan, by the Doctor Helicopter service, the scientist’s investigation concluded that FDP ‘must be a useful biochemical parameter for the initial evaluation of the severity of the trauma, even in blunt trauma patients without head injury or with stable vital signs’.

The study, which the researchers described a s the first of its kind, theorised that as FDP levels were shown as a good signifier for the severity of a head injury, it may also prove a good signifier for other trauma injuries. The researchers, made up from the Department of Acute Critical Care Medicine, Juntendo, and the Numazu City Hospital, then analysed 151 patients who had been taken to the hospital via air ambulance with severe trauma between February 2011 and July 2016.

The study aimed to help reduce the number of fatalities suffered in air ambulances by trying to prove that FDP levels could show whether a patient would need a transfusion or not in a patient. The patients were first spilt up into two groups; a survival group and a fatal group. The two groups were then compared over a range of data, including patients sex, age, presence of head injury, mechanism of injury, Glasgow Coma Scale on arrival, systolic blood pressure, heart rate, type of injury, injury severity score (ISS), FDP level at arrival, and base excess in a univariate analysis.

“There were no significant differences between the two groups with regard to age, sex and heart rate,” stated the study report. “However, the ratio of head injury, value of ISS, and the level of FDP in the fatal group were significantly greater than in the survival group. The average Glasgow Coma Scale, systolic blood pressure, and level of base excess in the fatal group were significantly smaller than in the survival group.”

From this, the researchers concluded: “This is the first study to show that among trauma patients transported by Doctor Helicopter the level of consciousness, blood pressure, ISS, FDP level, base excess, and the presence of head injury were associated with fatality. In addition, the FDP level at arrival had a positive correlation with anatomic traumatic severity.”

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