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Early leukocytosis in trauma patients: what difference does it make?
David C Chang1, Edward E Cornwell, Judith Phillips
1Division of Adult Trauma, Department of Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland 21287, USA.
Current Surgery
|February 20, 2004
Summary
Admission white blood cell count in trauma patients is linked to race and injury severity (Injury Severity Score > 15, Glasgow Coma Scale ≤ 8). However, it does not predict the need for resuscitation, transfusion, or surgery.
Area of Science:
- Trauma research
- Hematology
- Clinical diagnostics
Background:
- The white blood cell (WBC) count is a common laboratory test used in emergency medicine.
- Understanding factors influencing WBC count in trauma patients is crucial for accurate clinical assessment.
Purpose of the Study:
- To investigate the relationship between admission WBC count and patient demographics, injury characteristics, and the need for interventions in trauma patients.
- To identify predictors of elevated WBC count in the acute trauma setting.
Main Methods:
- Prospective data from 882 trauma admissions to a Level I trauma center were analyzed.
- T-tests and multiple linear regression with forward stepwise selection were employed.
- Variables included demographics, injury severity (ISS), Glasgow Coma Scale (GCS), and interventions.
Main Results:
- WBC count varied significantly with race, injury severity, and GCS score.
- Higher WBC counts were associated with white race, ISS > 15, and GCS ≤ 8.
- WBC count did not correlate with injury mechanism, specific organ damage, shock, or the need for transfusion or surgery.
Conclusions:
- Admission WBC count in trauma patients is influenced by race and injury severity.
- Elevated WBC count is not a reliable predictor for the need for volume resuscitation, blood transfusion, or surgical intervention.