000 03637cam a2200349 a 4500
003 EG-GiCUC
005 20250223031859.0
008 171217s2017 ua d f m 000 0 eng d
040 _aEG-GiCUC
_beng
_cEG-GiCUC
041 0 _aeng
049 _aDeposite
097 _aM.Sc
099 _aCai01.11.09.M.Sc.2017.Wa.P
100 0 _aWalaa Mohamed Zaki Mohamed
245 1 0 _aPrognostic value of estimated plasma fibrinogen level in comparison to measured fibrinogen level in traumatized critically Ill patients /
_cWalaa Mohamed Zaki Mohamed ; Supervised Emad Eldein Omar Abdalaziz , Mervat Mohamed Khalaf , Enas Abdalatif Ahmed
246 1 5 _aالقيمة التنبؤية للمستوى التقديرى للفيبرينوجين فى البلازما مقارنة بمستواة المقاس فى البلازما فى مرضى الاصابات الحرجة
260 _aCairo :
_bWalaa Mohamed Zaki Mohamed ,
_c2017
300 _a185 P. :
_bcharts ;
_c25cm
502 _aThesis (M.Sc.) - Cairo University - Faculty of Medicine- Department of Critical Care Medicine
520 _aBackground: Fibrinogen plays an important role in hemostasis and is the first coagulation factor to reach critical levels in massively bleeding trauma patients. rapid estimation of plasma fibrinogen (FIB) is essential upon emergency room (ER) admission, but is not part of routine coagulation monitoring in many centers. We investigated the predictive ability of the laboratory parameters hemoglobin (Hb) and base excess (BE) upon admission, as well as the Injury Severity Score (ISS), to estimate FIB in major trauma patients.also to predict mortality and morbidity in relation to these factors. Methods: In this prospective observational study, major trauma patients with documented FIB analysis upon ER admission were eligible for inclusion. FIB was correlated with Hb, BE and ISS, alone and in combination, using regression analysis. Results: A total of 80 critically ill trauma patients and 20 case control group were enrolled. FIB upon admission correlated strongly with Hb, BE and ISS. Multiple regression analysis showed that Hb , BE and ISS predicted FIB . using this equation model Estimated log Fibrinogen = 3.188+0.243HB - 0.019HB2 + 0.019BE - 0.05 ISS +0.0002 ISS2 we also predicted Cut off value for fibrinogen to predict survival: Fibrinogen level at 222.5 was predictive for survival with AUC, with sensitivity of 67.3% and specificity of 78% as p value was 0.0001. ISS group (5) had shown a significant higher frequency of all types of complications. By comparing the 3 ISS groups for age, hemodynamic, laboratory variables Critical group (ISS5) had a significantly lower SBP, PH, Hb, GCS and higher HR, RR, BE, INR, APACHE II and length of stay Conclusions: Upon ER admission, FIB of major trauma patients shows strong correlation with rapidly obtainable, routine laboratory parameters such as Hb and BE. These two parameters might provide an insightful and rapid tool to identify major trauma patients at risk of acquired hypofibrinogenemia. Early calculation of ISS could further increase the ability to predict FIB in these patients. We propose that FIB can be estimated during the initial phase of trauma care based on bedside tests
530 _aIssued also as CD
653 4 _aDIC
653 4 _aTIC
653 4 _aTrauma
700 0 _aEmad Eldein Omar Abdalaziz ,
_eSupervisor
700 0 _aEnas Abdalatif Ahmed ,
_eSupervisor
700 0 _aMervat Mohamed Khalaf ,
_eSupervisor
856 _uhttp://172.23.153.220/th.pdf
905 _aNazla
_eRevisor
905 _aShimaa
_eCataloger
942 _2ddc
_cTH
999 _c64070
_d64070