Eric J. Fish, Sonya C Hansen, E. Spangler, P. Gaillard, Shirley X Fan, L. Bacek
{"title":"129例急性外伤犬血清/血浆铁、红细胞分布宽度和有核红细胞的回顾性分析","authors":"Eric J. Fish, Sonya C Hansen, E. Spangler, P. Gaillard, Shirley X Fan, L. Bacek","doi":"10.1111/vec.12886","DOIUrl":null,"url":null,"abstract":"OBJECTIVE\nTo compare the prognostic value of admission hematologic parameters serum/plasma iron, red blood cell distribution width (RDW), and nucleated red blood cells (nRBCs) in dogs presenting with acute traumatic injury.\n\n\nDESIGN\nRetrospective observational study (2009-2015).\n\n\nSETTING\nUniversity teaching hospital.\n\n\nANIMALS\nOne hundred and twenty-nine clinical dogs presenting within 24 hours of acute traumatic injury.\n\n\nINTERVENTIONS\nNone.\n\n\nMEASUREMENTS AND MAIN RESULTS\nOne hundred and twenty-nine dogs met the inclusion criteria and 109 (84.5%) survived, while 20 (15.5%) died or were euthanized in hospital. Patients with blunt force trauma comprised 79.8% of the patient population; dogs with penetrating trauma comprised 20.2% of cases. Hypoferremia occurred in all nonsurvivors, and the median serum/plasma iron concentration was significantly lower in nonsurvivors than survivors (P = 0.028). Normal or increased serum/plasma iron had 100% specificity and 100% positive predictive value for survival. Red blood cell distribution width was not significantly different between groups (P = 0.417). The presence of nRBCs was significantly associated with nonsurvival (P = 0.030), although the absolute nRBC concentrations were not significantly different (P = 0.070). A multiple logistic regression model found age, type of injury, presence of nRBCs, and serum/plasma iron to be independent predictors of survival with an area under the receiver operator characteristic curve of 0.813.\n\n\nCONCLUSIONS\nThe presence of nRBCs and low serum/plasma iron are associated with mortality in patients with acute trauma; however, red blood cell distribution width was not associated with survival. Absence of hypoferremia was highly associated with a favorable prognosis in this patient population. These parameters may warrant inclusion in trauma scoring systems.","PeriodicalId":74015,"journal":{"name":"Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)","volume":" ","pages":""},"PeriodicalIF":0.0000,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/vec.12886","citationCount":"7","resultStr":"{\"title\":\"Retrospective evaluation of serum/plasma iron, red blood cell distribution width, and nucleated red blood cells in dogs with acute trauma (2009-2015): 129 cases.\",\"authors\":\"Eric J. Fish, Sonya C Hansen, E. Spangler, P. Gaillard, Shirley X Fan, L. Bacek\",\"doi\":\"10.1111/vec.12886\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"OBJECTIVE\\nTo compare the prognostic value of admission hematologic parameters serum/plasma iron, red blood cell distribution width (RDW), and nucleated red blood cells (nRBCs) in dogs presenting with acute traumatic injury.\\n\\n\\nDESIGN\\nRetrospective observational study (2009-2015).\\n\\n\\nSETTING\\nUniversity teaching hospital.\\n\\n\\nANIMALS\\nOne hundred and twenty-nine clinical dogs presenting within 24 hours of acute traumatic injury.\\n\\n\\nINTERVENTIONS\\nNone.\\n\\n\\nMEASUREMENTS AND MAIN RESULTS\\nOne hundred and twenty-nine dogs met the inclusion criteria and 109 (84.5%) survived, while 20 (15.5%) died or were euthanized in hospital. Patients with blunt force trauma comprised 79.8% of the patient population; dogs with penetrating trauma comprised 20.2% of cases. Hypoferremia occurred in all nonsurvivors, and the median serum/plasma iron concentration was significantly lower in nonsurvivors than survivors (P = 0.028). Normal or increased serum/plasma iron had 100% specificity and 100% positive predictive value for survival. Red blood cell distribution width was not significantly different between groups (P = 0.417). The presence of nRBCs was significantly associated with nonsurvival (P = 0.030), although the absolute nRBC concentrations were not significantly different (P = 0.070). A multiple logistic regression model found age, type of injury, presence of nRBCs, and serum/plasma iron to be independent predictors of survival with an area under the receiver operator characteristic curve of 0.813.\\n\\n\\nCONCLUSIONS\\nThe presence of nRBCs and low serum/plasma iron are associated with mortality in patients with acute trauma; however, red blood cell distribution width was not associated with survival. Absence of hypoferremia was highly associated with a favorable prognosis in this patient population. These parameters may warrant inclusion in trauma scoring systems.\",\"PeriodicalId\":74015,\"journal\":{\"name\":\"Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2019-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://sci-hub-pdf.com/10.1111/vec.12886\",\"citationCount\":\"7\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1111/vec.12886\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1111/vec.12886","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"","JCRName":"","Score":null,"Total":0}
Retrospective evaluation of serum/plasma iron, red blood cell distribution width, and nucleated red blood cells in dogs with acute trauma (2009-2015): 129 cases.
OBJECTIVE
To compare the prognostic value of admission hematologic parameters serum/plasma iron, red blood cell distribution width (RDW), and nucleated red blood cells (nRBCs) in dogs presenting with acute traumatic injury.
DESIGN
Retrospective observational study (2009-2015).
SETTING
University teaching hospital.
ANIMALS
One hundred and twenty-nine clinical dogs presenting within 24 hours of acute traumatic injury.
INTERVENTIONS
None.
MEASUREMENTS AND MAIN RESULTS
One hundred and twenty-nine dogs met the inclusion criteria and 109 (84.5%) survived, while 20 (15.5%) died or were euthanized in hospital. Patients with blunt force trauma comprised 79.8% of the patient population; dogs with penetrating trauma comprised 20.2% of cases. Hypoferremia occurred in all nonsurvivors, and the median serum/plasma iron concentration was significantly lower in nonsurvivors than survivors (P = 0.028). Normal or increased serum/plasma iron had 100% specificity and 100% positive predictive value for survival. Red blood cell distribution width was not significantly different between groups (P = 0.417). The presence of nRBCs was significantly associated with nonsurvival (P = 0.030), although the absolute nRBC concentrations were not significantly different (P = 0.070). A multiple logistic regression model found age, type of injury, presence of nRBCs, and serum/plasma iron to be independent predictors of survival with an area under the receiver operator characteristic curve of 0.813.
CONCLUSIONS
The presence of nRBCs and low serum/plasma iron are associated with mortality in patients with acute trauma; however, red blood cell distribution width was not associated with survival. Absence of hypoferremia was highly associated with a favorable prognosis in this patient population. These parameters may warrant inclusion in trauma scoring systems.