Document Type : Original Article
Department of Emergency Medicine, Kerman University of Medical Sciences, Kerman, Iran
Department of Biostatistics and Epidemiology, School of Public Health, University of Medical Sciences, Kerman, Iran
Background: To reduce mortality in patients with multiple-trauma, rapid diagnosis for blood transfusion is of great importance.
Objectives: The current study aimed at investigating the predictive role of red cell distribution width (RDW) in comparison with other multivariate systems to determine the need for blood transfusions in patients with trauma referred to hospital.
Methods: The follow-up study was conducted on patients with multiple-trauma aged ≥ 18 years with an injury severity score (ISS) ≥ 16 referred to the emergency department within the study period. All patients were evaluated based on the ATLS (the advanced trauma life support) guideline; then, blood samples were taken at arrival and 24 hours later to measure RDW. According to the questionnaire, age, gender, ISS, RTS (the revised trauma score), and TASH (the trauma-associated severe hemorrhage) score were recorded by a senior emergency medicine resident.
Results: Finally, 200 patients were enrolled in the study, of which 87 (43.5%) received blood transfusion. In the univariate analysis, there was a significant association between the first-day RDW, ∆ RDW (RDW on arrival - the first-day RDW), ISS, RTS, and TASH score, and blood transfusion. However, in the multivariate analysis, only TASH had a significant relationship with the need for blood transfusion (P < 0.0001).
Conclusions: Inmultiple trauma patients, rapid diagnosis of hemorrhage and the need for blood transfusion is crucial. Monitoring the patients based on the RDW test is not helpful in predicting the need for blood transfusion. Multivariate systems such as TASH score are more valuable in determining the need for blood transfusion.