Medicina intensiva · 2025
Early identification of hypofibrinogenemia in major trauma: The usefulness of the FiT-6 (Fibrinogen in Trauma-6) score.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Ruiz-Bocos Ángela, Sirgo Gonzalo, Cartanyà Marc, Canelles Sandra, Urgelés Silvia, Daniel Xavi, Murillo Natalia, Berrueta Julen, Aguinaco Reyes, Bodí María, Rodríguez Alejandro, Moreno Gerard
Аннотация
OBJECTIVE: To develop a clinical predictive score for hypofibrinogenemia in severely injured trauma patients.
DESIGN: Retrospective cohort study.
SETTING: Intensive Care Unit (ICU) at Hospital Joan XXIII.
PATIENTS: Consecutive patients admitted to the ICU for severe trauma with significant bleeding between 2015 and 2021 were included. Patients with an Injury Severity Score (ISS) < 16 were excluded.
INTERVENTIONS: Data were analyzed from the ICUTRAUMA registry, designed to establish the epidemiological profile of critically ill trauma patients in the province of Tarragona. The association between admission fibrinogen levels and ICU mortality was assessed using Cox regression with restricted cubic splines. A logistic regression model was then constructed to predict hypofibrinogenemia (≤203 mg/dl), from which a clinical score was developed and internally validated, and subsequently named FiT-6.
MAIN VARIABLES OF INTEREST: Association between initial fibrinogen levels and ICU mortality.
RESULTS: A non-linear relationship was observed between fibrinogen levels and ICU mortality. Fibrinogen levels ≤ 203 mg/dl were significantly associated with increased mortality (HR: 1.66; 95%CI: 1.01-2.72). Six independent predictors of hypofibrinogenemia were identified: ionic calcium < 1 mmol/l, hemoglobin < 10 g/dl, platelets < 100 × 109/l, base excess < -6, Shock Index > -0.9, and lactate > 2 mmol/l. The model demonstrated good diagnostic performance (AUC-ROC 0.90) after cross-validation.
CONCLUSIONS: The FiT-6 score shows high predictive ability for identifying hypofibrinogenemia, which is associated with increased ICU mortality.
DESIGN: Retrospective cohort study.
SETTING: Intensive Care Unit (ICU) at Hospital Joan XXIII.
PATIENTS: Consecutive patients admitted to the ICU for severe trauma with significant bleeding between 2015 and 2021 were included. Patients with an Injury Severity Score (ISS) < 16 were excluded.
INTERVENTIONS: Data were analyzed from the ICUTRAUMA registry, designed to establish the epidemiological profile of critically ill trauma patients in the province of Tarragona. The association between admission fibrinogen levels and ICU mortality was assessed using Cox regression with restricted cubic splines. A logistic regression model was then constructed to predict hypofibrinogenemia (≤203 mg/dl), from which a clinical score was developed and internally validated, and subsequently named FiT-6.
MAIN VARIABLES OF INTEREST: Association between initial fibrinogen levels and ICU mortality.
RESULTS: A non-linear relationship was observed between fibrinogen levels and ICU mortality. Fibrinogen levels ≤ 203 mg/dl were significantly associated with increased mortality (HR: 1.66; 95%CI: 1.01-2.72). Six independent predictors of hypofibrinogenemia were identified: ionic calcium < 1 mmol/l, hemoglobin < 10 g/dl, platelets < 100 × 109/l, base excess < -6, Shock Index > -0.9, and lactate > 2 mmol/l. The model demonstrated good diagnostic performance (AUC-ROC 0.90) after cross-validation.
CONCLUSIONS: The FiT-6 score shows high predictive ability for identifying hypofibrinogenemia, which is associated with increased ICU mortality.