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

Eric J. Fish, Sonya C Hansen, E. Spangler, P. Gaillard, Shirley X Fan, L. Bacek
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引用次数: 7

摘要

目的比较入院时血液学参数血清/血浆铁、红细胞分布宽度(RDW)和有核红细胞(nrbc)对急性创伤性损伤犬的预后价值。设计回顾性观察性研究(2009-2015)。大学教学医院。实验动物129只临床犬在24小时内出现急性创伤性损伤。干预措施及主要结果129只犬符合纳入标准,其中109只(84.5%)存活,20只(15.5%)在医院死亡或安乐死。钝器外伤患者占患者总数的79.8%;犬有穿透性创伤占20.2%。所有非幸存者均出现低铁血症,且非幸存者的中位血清/血浆铁浓度显著低于幸存者(P = 0.028)。正常或升高的血清/血浆铁具有100%特异性和100%阳性生存率预测值。各组红细胞分布宽度差异无统计学意义(P = 0.417)。尽管nRBC的绝对浓度没有显著差异(P = 0.070),但nRBC的存在与非生存率显著相关(P = 0.030)。多元logistic回归模型发现,年龄、损伤类型、nrbc的存在和血清/血浆铁是生存的独立预测因子,受体操作者特征曲线下面积为0.813。结论nrbc的存在和低血清/血浆铁与急性创伤患者的死亡率相关;然而,红细胞分布宽度与存活率无关。在这类患者中,无低铁血症与良好的预后高度相关。这些参数可能需要纳入创伤评分系统。
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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.
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