• Naoki Notani, Masashi Miyazaki, Shozo Kanezaki, Toshinobu Ishihara, Tomonori Sakamoto, Testsutaro Abe, Masashi Kataoka, and Hiroshi Tsumura.
• Department of Orthopedic Surgery, Faculty of Medicine, Oita University, Oita, Japan.
• Am J Emerg Med. 2020 Apr 1; 38 (4): 789-793.

ObjectiveThis study aimed to evaluate the usefulness of coagulation biomarkers as predictors of the need for massive transfusion (MT) in patients with pelvic fractures.MethodsPatients who were treated for pelvic fractures in our hospital were divided into 2 groups: MT and non-MT. MT was defined as the transfusion of packed red blood cells (PRBCs) ≧10 units caused by bleeding within 24 h after admission. We compared variables between two groups, including vital signs, the scoring system and blood sample test. Additionally, we performed a multiple logistic regression analysis and a receiver operating characteristic curve analysis to reveal which value was the most useful predictive marker for MT in patients with pelvic fracture.ResultsThere were 22 patients in the MT group and 78 patients in the non-MT group. Patients in the MT group had significantly higher ISS than did those in the non-MT group. In contrast, the patients in the MT group had significantly lower RTS, TRISS Ps, sBP, Hb, lactate, BE, and Fbg levels. Lower sBP and Fbg levels were independent predictors for MT. The optimal cut-off values for sBP and Fbg levels were ≦109 mmHg and 193.0 mg/dL, respectively.ConclusionsThe results of the study indicated that Fbg levels on admission can be an independent predictor of MT in patients with pelvic fractures. The optimal cut-off value of Fbg for MT prediction in this study was 193.0 mg/dL.Copyright © 2019 Elsevier Inc. All rights reserved.

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