ICJEM
Intercontinental Journal of Emergency Medicine

The Intercontinental Journal of Emergency Medicine aims to publish issues related to all fields of emergency medicine and all specialties involved in the management of emergencies in the hospital and prehospital environment of the highest scientific and clinical value at an international level and accepts articles on these topics. This journal is indexed by indices that are considered international scientific journal indices (DRJI, ESJI, OAJI, etc.). According to the current Associate Professorship criteria, it is within the scope of International Article 1-d. Each article published in this journal corresponds to 5 points.

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Original Article
Analysis of the hemogram and biochemistry parameters of patients with trauma
Abstract
Aims: Trauma-related deaths remain a significant public health concern, with organ complications in over 30% of multitrauma patients leading to high morbidity and mortality. This study aims to understand the changes and reliability of hemoglobin, hematocrit, AST, and ALT levels in trauma cases and their impact on treatment planning.
Methods: A retrospective analysis was conducted on 259 multitrauma patients admitted to Ankara Atatürk Training and Research Hospital between July and December 2012. Data on demographic details, trauma types, laboratory parameters, physical and tomographic examinations, treatment modalities, and outcomes were analyzed using SPSS software.
Results: The study group predominantly comprised males (74.9%) with a mean age of 42.15 years. Various trauma types were analyzed, including traffic accidents and falls. Significant fluctuations in hemoglobin and hematocrit levels were observed post-fluid resuscitation, regardless of bleeding status. Notably, AST and ALT levels were reliable indicators of hepatic injury. The study also highlighted the effects of fluid hydration volumes on hemoglobin and hematocrit levels.
Conclusion: The findings challenge the conventional understanding that drops in hemoglobin and hematocrit levels primarily indicate bleeding in multitrauma patients. Instead, these changes might also result from fluid resuscitation. The study underscores the importance of considering both bleeding and resuscitation efforts when interpreting these laboratory parameters. This study provides new insights into the interpretation of hemoglobin, hematocrit, AST, and ALT levels in trauma patients. It suggests a more nuanced approach in treatment planning, considering the significant impact of fluid resuscitation on these parameters, alongside bleeding.

Keywords : Trauma, emergency service, retrospective study, blood tests, demography

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1. Clark DE, Ryan LM. Concurrent prediction of hospital mortalityand length of stay from risk factors on admission. Health Serv Res.2002;37:631-645.
2. Moore FA, Sauaia A, Moore EE, Haenel JB, Burch JM, Lezotte DC.Postinjury multibl organ failurera bimodal phenoenon. J Trauma.1996;40:5001-512.
3. Regel G, Lobenhoffer P, Grotz M,Pape HC,Lehmann U,Tscheme H.Treatment results of patients with multibl trauma :an analysis of 3406cases treated between 1972 and 1991 at a German level I trauma çenter.J Trauma. 1995;38:70-78.
4. Moore FA, Moore EE. Trauma resuscitation. In: Wilmore DW, CheungLY, Harken AH, Holcroft JW, Meakins JL, Soper NJ (eds). AmericanCollege of Surgeons: ACS surgery. New York: WebMD Corporation,2002:31-37.
5. Nathens AB, Maier RV. Shock and resuscitation. In: Norton JA,Bollinger RR (eds). Essential Practice of Surgery. New York: Springer-Verlag, 2003:95-102.
6. Çelik Z. Anıl C. İntravenöz uygulama komplikasyonları. GüncelGastroenteroloji. 2004;8(2): 158-164.
7. Grathwohl KW, Bruns BJ, LeBrun CJ, Ohno AK, Dillard TA, CushnerHM. Does hemodilution exist? Effects of saline infusion on hematologicparameters in euvolemic subjects. South Med J. 1996;89(1):51-55.
8. Lobo DN, Stanga Z, Simpson JA, Anderson JA, Rowlands BJ, AllisonSP. Dilution and redistribution effects of rapid 2-litre infusions of 0.9%(w/v) saline and 5% (w/v) dextrose on hematological parameters andserum biochemistryin normal subjects: a double-blind crossover study.Clin Sci (Lond). 2001;101(2):173-179.
9. Lobo DN, Stanga Z, Aloysius MM, et al. Effect of volüme with 1liter intravenous infusions of 0.9% saline, 4% succinylated gelatine(gelfusine) and 6% hydrocyethyl starch (voluven) on blood volumeand endocrine responses: a randomized, threeway crossover studyinhealthy volunteers.Crit Care Med. 2010;38(2):464-470.
10. Karaaslan K, Durmufl M, But AK, Ersoy Ö, Arınç H. Akutnormovolemik hemodilüsyonun koroner arter bypass cerrahisindeetkileri. Türk Göğüs Kalp Damar Cer Derg. 2005;13:77-83.
11. Thorson CM, Ryan ML, Van Haren RM, et al. Change in hematocritduring trauma assessment predicts bleeding even with ongoing fluidresuscitation. Am Surg. 2013;79(4): 398-406.
12. Çakmakçı M, Sayek. Temel Cerrahi, Sayek. (Ed.) III. Baskı. Ankara:Güneş Kitabevi, 2004, 177-184.
13. Quispe-Cornejo AA, Alves da Cunha AL, Njimi H, et al. Effects ofrapid fluid infusion on hemoglobin concentration: a systematic reviewand meta-analysis. Crit Care. 2022;26(1): 324. doi: 10.1186/s13054-022-04191-x
14. Tan KK, Bang SL, Vijayan A, Chiu MT. Hepatic enzymes have a role inthe diagnosis of hepatic injury after blunt abdominal trauma. Injury.2009;40(9):978-983. doi: 10.1016/j.injury.2009.02.023
15. Sola JE, Cheung MC, Yang R, Koslow S, Lanuti E, Seaver C, NevilleHL, Schulman CI. Pediatric FAST and elevated liver transaminases:An effective screening tool in blunt abdominal trauma. J Surg Res.2009;157(1):103-107. doi: 10.1016/j.jss.2009.03.058
16. Hennes HM, Smith DS, Schneider K, Hegenbarth MA, Duma MA, JonaJZ. Elevated liver transaminase levels in children with blunt abdominaltrauma: apredictor of liver injury. Pediatrics. 1990;86(1):87-90.
17. Kumar S, Sagar S, Subramanian A, Albert V, Pandey RM, Kapoor N.Evaluation of amylase and lipase levels in blunt trauma abdominalpatients. J Emerg Trauma Shock. 2012;5(2):135-142. doi: 10.4103/0974-2700.96482
18. Tian Z, Liu H, Su X, et al. Role of elevated liver transaminase levels inthe diagnosis of liver injury after blunt abdominal trauma. Exp TherMed. 2012;4(2):255-260.
19. Bevan CA, Palmer CS, Sutcliffe JR, Rao P, Gibikote S, Crameri J. Bluntabdominal trauma in children: how predictive is ALT for liver injury?Emerg Med J. 2009;26(4):283-288. doi: 10.1136/emj.200X.062703
20. Zhao DW, Tian M, Zhang LT, et al. Effectiveness of contrast-enhancedultrasound and serum liver enzyme measurement in detection andclassification of blunt liver trauma. J Int Med Res. 2017; 45(1):170-181.doi: 10.1177/0300060516678525
21. Bilgic I, Gelecek S, Akgun AE, Ozmen MM. Predictive value ofliver transaminases levels in abdominal trauma. Am J Emerg Med.2014;32(7):705-708. doi: 10.1016/j.ajem.2014.03.052
22. Kirbi M, Grad A, Megli C B, Bajrovi C FF. Comparison of activestanding test, head-up tilt test and 24-h ambulatory heart rate andblood pressure monitoring in diagnosing postural tachycardia. FunctNeurol. 2013;28(1):39-45.
23. Zhang QF, Zhou HM, Wang CJ, Shao HB. Influence of high-voltageelectric burn on the microcirculation of heart in rabbit Zhonghua ShaoShang Za Zhi. 2012;28(3):173-177.
24. Kumar S, Sagar S, Subramanian A, Albert V, Pandey RM, Kapoor N.Evaluation of amylase and lipase levels in blunt trauma abdominalpatients. J Emerg Trauma Shock. 2012;5(2):135-142. doi: 10.4103/0974-2700.96482
25. Batman F, Aydınlı M, Sayek İ. Karaciğer fonksiyonlarınındeğerlendirilmesi. Temel Cerrahi. 2004;1295-1301.
Article available in :
Volume 2, Issue 3, 2024
Page : 56-63
https://doi.org/10.51271/ICJEM-0039
Article Information
Received : 01 Eyl 2024
Accepted : 23 Eyl 2024
Published : 28 Eyl 2024
Corresponding Author :

Fatih Ahmet Kahraman: Department of Emergency Medicine, Ankara Bilkent City Hospital, Ankara, Turkiye

[email protected]
Citation : Kahraman FA, Şahin Kavaklı H, İçme F, Otal Y, Şener A. Analysis of the hemogram and biochemistry parameters of patients with trauma. Intercont J Emerg Med. 2024;2(3):56-63.

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