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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| Format: | Article |
| Language: | English |
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Wiley
2022-01-01
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| Series: | Emergency Medicine International |
| Online Access: | http://dx.doi.org/10.1155/2022/7219812 |
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| author | Dongyup Baik Seok-Ran Yeom Sung-Wook Park Youngmo Cho Wook Tae Yang Hoon Kwon Jae Il Lee Jun-Kyeung Ko Hyuk Jin Choi Up Huh Tae Sik Goh Chan-Hee Song Lee Hwangbo Il Jae Wang |
| author_facet | Dongyup Baik Seok-Ran Yeom Sung-Wook Park Youngmo Cho Wook Tae Yang Hoon Kwon Jae Il Lee Jun-Kyeung Ko Hyuk Jin Choi Up Huh Tae Sik Goh Chan-Hee Song Lee Hwangbo Il Jae Wang |
| author_sort | Dongyup Baik |
| collection | DOAJ |
| 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. |
| format | Article |
| id | doaj-art-ee416401e9e4416ba31de747e05b0044 |
| institution | Kabale University |
| issn | 2090-2859 |
| language | English |
| publishDate | 2022-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Emergency Medicine International |
| spelling | doaj-art-ee416401e9e4416ba31de747e05b00442025-02-03T06:12:26ZengWileyEmergency Medicine International2090-28592022-01-01202210.1155/2022/7219812The Addition of ROTEM Parameter Did Not Significantly Improve the Massive Transfusion Prediction in Severe Trauma PatientsDongyup Baik0Seok-Ran Yeom1Sung-Wook Park2Youngmo Cho3Wook Tae Yang4Hoon Kwon5Jae Il Lee6Jun-Kyeung Ko7Hyuk Jin Choi8Up Huh9Tae Sik Goh10Chan-Hee Song11Lee Hwangbo12Il Jae Wang13Department of Emergency MedicineDepartment of Emergency MedicineDepartment of Emergency MedicineDepartment of Emergency MedicineDepartment of Emergency MedicineDepartment of RadiologyDepartment of NeurosurgeryDepartment of NeurosurgeryDepartment of NeurosurgeryDepartment of Thoracic and Cardiovascular SurgeryDepartment of Orthopaedic SurgeryDepartment of Biomedical EngineeringDepartment of RadiologyDepartment of Emergency MedicineBackground. 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.http://dx.doi.org/10.1155/2022/7219812 |
| spellingShingle | Dongyup Baik Seok-Ran Yeom Sung-Wook Park Youngmo Cho Wook Tae Yang Hoon Kwon Jae Il Lee Jun-Kyeung Ko Hyuk Jin Choi Up Huh Tae Sik Goh Chan-Hee Song Lee Hwangbo Il Jae Wang The Addition of ROTEM Parameter Did Not Significantly Improve the Massive Transfusion Prediction in Severe Trauma Patients Emergency Medicine International |
| 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 |
| url | http://dx.doi.org/10.1155/2022/7219812 |
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