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중증 외상 환자에서의 다발성 장기부전 발생 예측에 있어 젖산/알부민값의 유용성

Other Titles
 The prognostic usefulness of the lactate/albumin ratio for predicting multiple organ dysfunction syndrome in severe trauma 
Authors
 한상우  ;  정성필  ;  좌민홍  ;  유제성  ;  공태영  ;  박정민  ;  박인철 
Citation
 Journal of the Korean Society of Emergency Medicine (대한응급의학회지), Vol.33(1) : 45-60, 2022-02 
Journal Title
Journal of the Korean Society of Emergency Medicine(대한응급의학회지)
ISSN
 1226-4334 
Issue Date
2022-02
Keywords
Trauma ; Multiple organ dysfunction syndrome ; Lactic acid ; Albumins ; Prognosis
Abstract
Objective:
Early prediction of the multiple organ dysfunction syndrome (MODS) and providing early innovative treatment may improve outcomes in patients with severe trauma. Lactate and serum albumin levels, which are widely used markers predicting the severity of critically ill patients, tend to diverge during clinical deterioration. This study aimed to evaluate the clinical utility of the lactate/albumin ratio (LAR) as a predictive factor for MODS and 30-day mortality in patients with severe trauma.
Method:
This retrospective, observational cohort study was performed with patients prospectively integrated into a critical pathway for trauma. We analyzed severe trauma patients (Injury Severity Score≥16) admitted to the emergency department (ED), between January 1, 2011, and May 31, 2017. The outcomes were the development of MODS and 30-day mortality.
Results:
In total, 348 patients were enrolled, of which 18 (5.2%) died within 96 hours of ED admission, and the remaining 330 patients (94.8%) were evaluated for the development of MODS. An increase in the LAR at admission (odds ratio, 1.618; P=0.028) was an independent predictor of MODS development. The area under the receiver operating characteristic curve (0.755) and Harrell's C-index (0.783) showed that LAR could predict MODS and 30-day mortality.
Conclusion:
Initial LAR is an independent predictor of MODS development in patients with severe trauma. Our study results suggest that an elevated LAR can be a useful prognostic marker in patients with severe trauma.
Files in This Item:
T202203680.pdf Download
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Emergency Medicine (응급의학교실) > 1. Journal Papers
Yonsei Authors
Kong, Tae Young(공태영) ORCID logo https://orcid.org/0000-0002-4182-7245
Park, In Cheol(박인철) ORCID logo https://orcid.org/0000-0001-7033-766X
You, Je Sung(유제성) ORCID logo https://orcid.org/0000-0002-2074-6745
Chung, Sung Phil(정성필) ORCID logo https://orcid.org/0000-0002-3074-011X
Choa, Min Hong(좌민홍) ORCID logo https://orcid.org/0000-0003-0338-994X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/191221
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