中国输血杂志2025，Vol.38Issue(6)：788-796,9.DOI:10.13303/j.cjbt.issn.1004-549x.2025.06.007
创伤患者相关监测指标对首日红细胞用量预测价值的探索
Predictive value of trauma related monitoring indicators for first-day red blood cell transfusion volume in trauma patients
摘要
Abstract
Objective To retrospectively analyze the early monitoring indicators before and after admission,the use of coagulation/anticoagulant medications,and the red blood cell transfusion within 24 hours in emergency trauma patients,and to identify the indicators related to the volume of red blood cells transfused during the first 24 hours of hopitalization,thereby assisting clinical judgment of the probability and required quantity of red blood cell transfusion.Methods Data of 117 e-mergency trauma patients admitted to intensive care unit(ICU)from January 2022 to March 2024 were retrospectively ana-lyzed.Patients were categorized according to whether the volume of red blood cells transfused within 24 hours exceeded spe-cific quartile thresholds(Q1,Q2,Q3).Non-parametric tests were used for numerical variables and Chi-square tests were used for categorical variables to identify statistically significant single-factor indicators,which were subsequently incoporated into a binary logistic regression model to obtain a combined predictive probability.ROC curve analysis was performed on the multi-factor indicators and their combined predictive probability derived from the binary logistic regression model.Results 1)The initial hemoglobin(Hb)and hematocrit(Hct)levle were independent influencing factors in the group with red blood cell transfusion volume exceeded Q1(P<0.05),and the combined predictive probability demostrated by ROC curve analy-sis was AUC=0.858(P<0.05).2)In the group of red blood cell transfusion volume exceeding Q2,the initial Fib,tran-shulitic acid,human prothrombin complex,trauma category and primary trauma site were independent influencing factors(P<0.05),and the combined predictive probability of ROC curve analysis was AUC=0.966(P<0.05).3)Pulse pres-sure and trauma category were independent influencing factors in the group with red blood cell transfusion volume exceeding Q3(P<0.05),and ROC curve analysis revealed that combined prediction probability was AUC=0.944(P<0.05).Con-clusion Early monitoring indicators and the use of coagulation medications,before and after admission in emergency trau-ma patients show diagnostic value in predicting the amount of red blood cells transfused on the first day of admission.Early warning alerts established through patient monitoring indicators can reduce incidents of untimely blood supply from the blood transfusion department(blood bank)for emergency trauma patients with massive hemorrhage,especially for patients with rare blood types or during blood supply shortage.关键词
创伤患者相关监测指标/首日输注红细胞量/ROC曲线联合诊断概率Key words
trauma-related monitoring indicators/red blood cell transfusion on the first day/ROC curve combined pre-dictive probability分类
医药卫生引用本文复制引用
杨劲,胡志航,蒋先孝,陈良,李海山..创伤患者相关监测指标对首日红细胞用量预测价值的探索[J].中国输血杂志,2025,38(6):788-796,9.基金项目
安徽医科大学校科研基金(2020xkj251) （2020xkj251）
合肥市第二人民医院院级科研(2023ylc016) （2023ylc016）
