Elevated K/iCa ratio is an ancillary predictor for mortality in patients with severe hemorrhage: A decision tree analysis.

Adult Blood Transfusion / methods Decision Trees Hemorrhage Humans Retrospective Studies Trauma Centers Wounds and Injuries / complications
Hyperkalemia Hypocalcemia K/iCa ratio Massive transfusion protocol Trauma

Journal

American journal of surgery
ISSN: 1879-1883
Titre abrégé: Am J Surg
Pays: United States
ID NLM: 0370473

Informations de publication

Date de publication:
06 2022
Historique:
received: 02 09 2021
revised: 22 11 2021
accepted: 07 12 2021
pubmed: 22 12 2021
medline: 28 6 2022
entrez: 21 12 2021
Statut: ppublish

Résumé

Trauma patients receiving massive transfusion protocol (MTP) are at risk of citrate-induced hypocalcemia and hyperkalemia. Here we evaluate potassium (K), ionized calcium (iCa), and K/iCa ratio as predictors of mortality. This retrospective study includes all adult trauma patients who received MTP within 1 h at our level I trauma center between 2014 and 2019. Receiver operating characteristic curve analysis assessed predictive accuracy of K/iCa ratio at admission on 120-day mortality. Of 614 patients, 146 received MTP within 1 h and 38 expired. Patients who expired had higher K/iCa ratio than survivors (median [IQR] = 5.7 [3.8-7.2] vs 3.7 [3.1-4.9], p < 0.001). Area under the curve of K/iCa was 0.72 (95%CI = 0.62-0.82, p < 0.001) with sensitivity = 63.2% and specificity = 77.6%. At the optimum K/iCa cutoff (5.07), patients with high ratios had 4 times higher mortality risk (HR = 3.97, 95%CI = 1.89-8.32, p < 0.001). Elevated K/iCa ratio was an independent predictor of mortality in trauma patients managed with MTP.

Identifiants

DOI: 10.1016/j.amjsurg.2021.12.011 PMID: 34930584
pubmed: 34930584
pii: S0002-9610(21)00737-6
doi: 10.1016/j.amjsurg.2021.12.011
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

1187-1193

Informations de copyright

Copyright © 2021 Elsevier Inc. All rights reserved.

Auteurs

Scott Ninokawa (S)

Tulane University School of Medicine, Department of Surgery, New Orleans, LA, USA. Electronic address: sninokawa@tulane.edu.

Danielle Tatum (D)

Tulane University School of Medicine, Department of Surgery, New Orleans, LA, USA; Our Lady of the Lake Regional Medical Center, Baton Rouge, LA, USA. Electronic address: dtatum@tulane.edu.

Eman Toraih (E)

Tulane University School of Medicine, Department of Surgery, New Orleans, LA, USA; Genetics Unit, Department of Histology and Cell Biology, Faculty of Medicine, Suez Canal University, Ismailia, Egypt. Electronic address: etoraih@tulane.edu.

Kristen Nordham (K)

Tulane University School of Medicine, Department of Surgery, New Orleans, LA, USA. Electronic address: knordham@tulane.edu.

Michael Ghio (M)

Tulane University School of Medicine, Department of Surgery, New Orleans, LA, USA. Electronic address: mghio@tulane.edu.

Sharven Taghavi (S)

Tulane University School of Medicine, Department of Surgery, New Orleans, LA, USA. Electronic address: staghavi@tulane.edu.

Chrissy Guidry (C)

Tulane University School of Medicine, Department of Surgery, New Orleans, LA, USA. Electronic address: cguidry@tulane.edu.

Patrick McGrew (P)

Tulane University School of Medicine, Department of Surgery, New Orleans, LA, USA. Electronic address: pmcgrew@tulane.edu.

Rebecca Schroll (R)

Tulane University School of Medicine, Department of Surgery, New Orleans, LA, USA. Electronic address: rschroll@tulane.edu.

Charles Harris (C)

Tulane University School of Medicine, Department of Surgery, New Orleans, LA, USA. Electronic address: charris12@tulane.edu.

Juan Duchesne (J)

Tulane University School of Medicine, Department of Surgery, New Orleans, LA, USA. Electronic address: jduchesn@tulane.edu.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female

Evaluation of Low-Value Services Across Major Medicare Advantage Insurers and Traditional Medicare.

Ciara Duggan, Adam L Beckman, Ishani Ganguli et al.
1.00
Humans United States Aged Cross-Sectional Studies Medicare Part C

Effectiveness of Virtual Yoga for Chronic Low Back Pain: A Randomized Clinical Trial.

Hallie Tankha, Devyn Gaskins, Amanda Shallcross et al.
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Elevated K/iCa ratio is an ancillary predictor...
questionsmedicales.fr › Thérapeutique › Biothérapie › Transfusion sanguine › Elevated K/iCa ratio is an ancillary predictor...
questionsmedicales.fr › Concepts mathématiques › Théorie de la décision › Arbres de décision › Elevated K/iCa ratio is an ancillary predictor...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Hémorragie › Elevated K/iCa ratio is an ancillary predictor...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Elevated K/iCa ratio is an ancillary predictor...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Elevated K/iCa ratio is an ancillary predictor...
questionsmedicales.fr › Administration des services de santé › Organisation et administration › Administration d'établissement de santé › Administration hospitalière › Services hospitaliers › Service hospitalier d'urgences › Centres de traumatologie › Elevated K/iCa ratio is an ancillary predictor...
questionsmedicales.fr › Plaies et blessures › Elevated K/iCa ratio is an ancillary predictor...