Is early leukocytosis a predictor of hemoglobin drop in trauma patients?

Abstract

Objective: The objective of this study was to determine whether white blood cell (WBC) count at admission can predict hemoglobin (Hb) drop in multiple trauma patients and can be considered a predictive sign for the need for transfusion of packed red blood cells in multiple trauma patients. Patients and Methods: This retrospective study was performed on 227 trauma patients, evaluated over a 30-month period (January 2014 to July 2016). Data collected included demographics, injuries, leukocyte count, and Hb at admission time of 0, 24 h, 48 h, transfusion requirement. Leukocytosis and Hb drop were defined as leukocyte count ≥16,000/mm3 and 2 g/dL, respectively. We compared two groups of multiple trauma patients with leukocytosis at admission time and normal WBC count with Hb drop in hospital course. The patients had similar injury severity scores. Data were analyzed by SPSS version 21. Results: Of the 227 patients admitted for durations longer than 24 h, WBC count was available for them. Leukocyte count showed a strong association with severe injury (P = 0.01). The logistic regression was used for the prediction of Hb drop of participant. The Cox and Snell R Square and Nagelkerke R Square indicated that the variances in this research between 0.006 and 0.008 have been explanations. Conclusion: The results showed that early leukocytosis has a relationship with severity of injury, but it is not beneficial in predicting Hb drop and transfusion requirement.