The Factors Associated With Decreasing Hemoglobin Levels and Platelet Counts After Trauma

TL;DR

This study identifies factors linked to drops in hemoglobin and platelet counts in trauma patients, such as age, blood pressure, and specific biomarkers.

Contribution

The study identifies novel independent risk factors for hemoglobin and platelet changes in trauma patients using multivariate analysis.

Findings

FDP level, IVC diameter, and age are significantly associated with hemoglobin level changes.

IVC diameter, LDH, age, systolic blood pressure, and sex are significantly associated with platelet count changes.

Findings suggest a need for further research in larger trauma patient populations.

Abstract

Objective

In this study, we investigated the factors related to anemia and platelet reduction in patients with moderate to severe trauma to gain a deeper understanding of these phenomena.

Methods

Our study spanned the period from April 2021 to September 2023, and it involved a retrospective review of the hospital medical charts of all emergency outpatients of all ages who were transported by a physician-staffed helicopter and treated at our hospital and were diagnosed with an Injury Severity Score (ISS) of >8 by CT on arrival. The following data were analyzed: sex; age; mechanism of injury; vital signs upon arrival at the hospital; ISS; hemoglobin level and platelet count on arrival and day two; fibrin degradation product (FDP) level, lactate dehydrogenase (LDH) level, and diameter of the inferior vena cava (IVC) on arrival; and infusion volume on day one. We then statistically calculated the independent risk factors for differences between hemoglobin levels and platelet counts on arrival and those on day two.

Results

The study included a total of 209 subjects, with an average age of 58 years and a male predominance. Multivariate analysis showed that the FDP level, IVC diameter, and age were significantly associated with changes in hemoglobin levels on arrival and day two, whereas the IVC diameter, LDH, age, systolic blood pressure, and sex were significantly associated with changes in the platelet count on arrival and day two.

Conclusions

A noteworthy correlation was found between certain factors and changes in hemoglobin levels and platelet counts between the initial assessment and the second day in our cohort. We recommend further prospective research to determine whether our findings hold true for a larger population of trauma patients.