Significance of the initial spun hematocrit in trauma patients

This study was designed to determine whether the initial spun hematocrit (HCT) value correlated with blood loss requiring operative intervention (OR). A spun HCT was performed on the first available blood sample from 524 admitted patients 12 years of age or older with traumatic injuries (86% blunt, 14% penetrating). Patients in the OR (n = 66) group had a lower mean HCT (35 v 41, P < .001) when compared with the non-OR group. The 81 patients with an HCT of < or = 35 required OR more frequently (41% v 7%, P < .001). An HCT of < or = 35 had a sensitivity of 50%, specificity of 90%, positive predictive value of 41%, and negative predictive value of 93% for identifying the OR group. The effect of hemodilution from intravenous fluid is difficult to assess in a retrospective clinical study.