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J Korean Soc Emerg Med > Volume 31(2); 2020 > Article
Journal of The Korean Society of Emergency Medicine 2020;31(2): 169-180.
응급센터에 내원한 중증외상환자에서 평균혈소판용적의 연속 측정을 통한 다발성 장기부전 예측의 유용성
양현영1, 정성필1, 좌민홍1, 유제성1, 공태영1 , 고동률1,2, 황윤정1, 이용희1, 조영준1, 박인철1, 김시내3
1연세대학교 의과대학 응급의학교실
2강원대학교 대학원 의학과 응급의학교실
3연세대학교 의과대학 연구부 통계지원실
Usefulness of serial measurement of the mean platelet volume to predict multiple organ dysfunction syndrome in patients with severe trauma
Hyun Young Yang1, Sung Phil Chung1, Minhong Choa1, Je Sung You1, Taeyoung Kong1 , Dong Ryul Ko1,2, Yoon Jung Hwang1, Yong Hee Lee1, Young Joon Cho1, Incheol Park1, Sinae Kim3
1Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Korea
2Department of Emergency Medicine, Graduate School of Medicine, Kangwon National University, Chuncheon, Korea
3Department of Research Affairs, Biostatistics Collaboration Unit, Yonsei University College of Medicine, Seoul, Korea
Correspondence  Taeyoung Kong ,Tel: 02-2019-3030, Fax: 02-2019-4820, Email: grampian@yuhs.ac,
Received: August 16, 2019; Revised: October 23, 2019   Accepted: October 24, 2019.  Published online: April 30, 2020.
The early prediction of multiple organ dysfunction syndrome (MODS) in trauma patients and provision of prompt treatment may improve their outcomes. We investigated the efficacy of the mean platelet volume (MPV) for predicting MODS in cases of severe trauma.
This retrospective, observational cohort study was performed with patients prospectively integrated in a critical pathway of TRAUMA. We analyzed the severe trauma patients admitted to the emergency department (ED), based on the Advanced Trauma Life Support guideline, between January 1, 2011 and May 31, 2017. The outcomes were developed from MODS at least 48 hours after ED admission.
A total of 348 patients were enrolled. An increase in the MPV at 12 hours (odds ratio [OR], 2.611; P<0.001) was a strong independent predictor of MODS development. The increasing predictability of MODS was closely associated with an MPV at 12 hours>8.6 fL (OR, 4.831; P<0.001). The area under the receiver operating characteristic curve (AUROC) value of the MPV at 12 hours (0.751; 95% confidence interval [CI], 0.687-0.818; P<0.01) was not inferior than that of Acute Physiology and Chronic Health Evaluation II score, injury severity score, lactate, and total CO2 for predicting MODS.
MPV was an independent predictor of MODS development in severe trauma patients. Emergency physicians can use the MPV as an ancillary biomarker for predicting MODS.
Key words: Trauma; Multiple organ dysfunction syndrome; Mean platelet volume; Prognosis
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