دورية
乳酸値とフィブリノゲンは産科危機的出血に対する大量輸血の予測因子となりえる(Lactate and fibrinogen as good predictors of massive transfusion in postpartum hemorrhage)
| العنوان: | 乳酸値とフィブリノゲンは産科危機的出血に対する大量輸血の予測因子となりえる(Lactate and fibrinogen as good predictors of massive transfusion in postpartum hemorrhage) |
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| المؤلفون: | (Asami Okada), 岡田 麻美, (Yohei Okada), 岡田 遥平, (Motoi Inoue), 井上 基, (Hiromichi Narumiya), 成宮 博理, (Osamu Nakamoto), 中本 収 |
| المصدر: | Journal of Japanese Association for Acute Medicine; October 2019, Vol. 30 Issue: 10 p914-919, 6p |
| مستخلص: | 【目的】産後出血に対する大量輸血の予測因子の同定を目的とした。【方法】対象は産後出血で母体搬送された連続60症例。来院後24時間以内にRBC10単位以上輸血された症例を大量輸血群（MT群），10単位未満を非MT群に分け，年齢，BMI，バイタルサイン，採血結果について2群間で比較し，単変量解析を行った。【結果】31名が参加基準を満たした（MT群19名）。2群間比較でフィブリノゲン（Fib）と乳酸値のみが有意差を認めた。SIは有意差を認めなかった。Fib，乳酸値を説明変数とし，大量輸血の有無を目的変数とした単変量解析の結果，Fibの単位オッズ比は0.98 [95% CI: 0.97–0.99]，乳酸値の単位オッズ比は1.62 [95% CI: 1.08–3.02]であった。【結論】Fibと乳酸値が産後出血における大量輸血の予測因子として有用な可能性がある。 Aim: This study aims to identify the clinical factors that can predict the requirement of massive transfusion among patients with postpartum hemorrhage (PPH). Methods: Consecutive anonymized patients with PPH who were treated at the emergency department of our perinatal medical center were examined. Patients who had received transfusions before admission, those who had cardiac arrest on arrival, and those without history of blood gas analysis were excluded. Our primary outcome was the requirement of massive transfusion defined as packed red blood cells of ≥10units/24h. Univariable logistic analysis was conducted to identify the odds ratio (OR) and 95% confidence interval (CI) of the explanatory variables for the outcome. Results: A total of 31 patients (massive transfusion, n=19) were included in the main analysis. The crude OR for fibrinogen per mg/dL and lactate per mmol/L were calculated as 0.98 (95% CI: 0.97–0.99) and 1.62 (95% CI: 1.08–3.02), respectively. The area under the curve for fibrinogen and lactate were 0.814 and 0.734, respectively, and optimal cut–off values for fibrinogen and lactate were 211mg/dL and 4mmol/L, respectively. Conclusion: These findings suggest that lactate and fibrinogen can be predictors for the requirement of massive transfusion in patients with PPH. |
| قاعدة البيانات: | Supplemental Index |
| تدمد: | 0915924X 18833772 |
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| DOI: | 10.1002/jja2.12386 |