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Association of hemoglobin concentration and mortality in critically ill patients with severe traumatic brain injury

Overview of attention for article published in Critical Care, July 2012
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About this Attention Score

  • Above-average Attention Score compared to outputs of the same age (61st percentile)
  • Above-average Attention Score compared to outputs of the same age and source (55th percentile)

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3 tweeters

Citations

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74 Dimensions

Readers on

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89 Mendeley
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Title
Association of hemoglobin concentration and mortality in critically ill patients with severe traumatic brain injury
Published in
Critical Care, July 2012
DOI 10.1186/cc11431
Pubmed ID
Authors

Sekhon MS, McLean N, Henderson WR, Chittock DR, Griesdale DE

Abstract

ABSTRACT: INTRODUCTION: The critical care management of traumatic brain injury focuses on preventing secondary ischemic injury. Cerebral oxygen delivery is dependent upon the cerebral perfusion pressure and the oxygen content of blood, which is principally determined by hemoglobin. Despite its importance to the cerebral oxygen delivery, the precise hemoglobin concentration to provide adequate oxygen delivery to injured neuronal tissue in TBI patients is controversial with limited evidence to provide transfusion thresholds. METHODS: We conducted a retrospective cohort study of severe TBI patients, investigating the association between mean 7-day hemoglobin concentration and hospital mortality. Demographic, physiologic, intensive care interventions, clinical outcomes and daily hemoglobin concentrations were recorded for all patients. Patients were all cared for at a tertiary, level 1 trauma center in a mixed medical and surgical intensive unit. Patients were divided into quartiles based on their mean 7-day hemoglobin concentration: < 90 g/L, 90 - 99 g/L, 100 - 109 g/L and > 110 g/L. Multivariable log-binomial regression was used to model the association between mean daily hemoglobin concentration and hospital mortality. RESULTS: Two hundred seventy-three patients with traumatic brain injury were identified and 169 were included in the analysis based on inclusion/exclusion criteria. Of these, 77% of the patients were male, with a mean age of 38 (SD 17) years and a median best GCS of 6 (IQR 5 - 7). One hundred fifteen patients (68%) received a red blood cell (RBC) transfusion. In RBCs administered in the ICU, the median pre-transfusion hemoglobin was 79 g/L (IQR 73 - 85). Thirty-seven patients (22%) died in hospital. Multivariable analysis revealed that mean 7-day hemoglobin concentration < 90 g/L was independently associated with an increased risk of hospital mortality (RR 3.1, 95% CI 1.5 - 6.3, p = 0.03). Other variables associated with increased mortality on multivariable regression were insertion of external ventricular drain, age and decreased GCS. Red blood cell transfusion was not associated with mortality following multivariable adjustment. CONCLUSIONS: A mean 7-day hemoglobin concentration of < 90g/L is associated with increased hospital mortality in patients with severe traumatic brain injury.

Twitter Demographics

The data shown below were collected from the profiles of 3 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 89 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Brazil 2 2%
Czechia 1 1%
Switzerland 1 1%
United States 1 1%
Unknown 84 94%

Demographic breakdown

Readers by professional status Count As %
Student > Master 14 16%
Other 14 16%
Student > Postgraduate 13 15%
Researcher 11 12%
Professor > Associate Professor 7 8%
Other 19 21%
Unknown 11 12%
Readers by discipline Count As %
Medicine and Dentistry 62 70%
Nursing and Health Professions 3 3%
Neuroscience 2 2%
Immunology and Microbiology 1 1%
Computer Science 1 1%
Other 4 4%
Unknown 16 18%

Attention Score in Context

This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 11 January 2013.
All research outputs
#1,722,576
of 3,632,901 outputs
Outputs from Critical Care
#1,173
of 2,162 outputs
Outputs of similar age
#26,073
of 71,935 outputs
Outputs of similar age from Critical Care
#53
of 120 outputs
Altmetric has tracked 3,632,901 research outputs across all sources so far. This one has received more attention than most of these and is in the 50th percentile.
So far Altmetric has tracked 2,162 research outputs from this source. They receive a mean Attention Score of 4.1. This one is in the 42nd percentile – i.e., 42% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 71,935 tracked outputs that were published within six weeks on either side of this one in any source. This one has gotten more attention than average, scoring higher than 61% of its contemporaries.
We're also able to compare this research output to 120 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 55% of its contemporaries.