Correlation of Early Total Leucocyte Count and Red Cell Distribution Width With Outcome in Trauma

Correlation of Early Total Leucocyte Count and Red Cell Distribution Width With Outcome in Trauma | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Original Research Correlation of Early Total Leucocyte Count and Red Cell Distribution Width With Outcome in Trauma Bhavana Chowdary Madineni, Sreeramulu P N This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-134788/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Trauma is the leading cause of death in young adults. Risk stratification in patients with trauma remains challenging. There is a need for a readily available prognostic method to categorise these patients. Aims & Objectives: We aim to measure and correlate red cell distribution width and total leucocyte count in patients presenting with trauma within 24 hours of injury with the outcome. Methods: We included 52 trauma patients who were admitted in RLJH from November 2019 to April 2020, who did not require emergency surgery and analysed prospectively. Complete blood picture within 24 hours of injury was analysed and outcome measured in terms of length of hospital stay. Results: There was a statistically significant correlation found between TLC and Length of hospital stay (p<0.001). The correlation between RDW and Length of hospital stay was not statistically significant. The analysis showed that increased hospital stay was associated with high TLC and RDW% done within 24 hours of injury. Conclusion: TLC and RDW can be used as readily available and simple markers in early prediction of higher morbidity in patients presenting with trauma. Critical Care & Emergency Medicine Injuries polytrauma blood cell count leucocytosis red cell indices Figures Figure 1 Figure 2 Figure 3 Introduction Trauma is any physical injury caused by a sudden or brief encounter with various levels of energy. The word 'trauma' comes from a Greek word which means 'wound'.The most common cause of trauma being road traffic accidents. Trauma is the leading cause of death in children and young adults. Worldwide, it accounts for the death of approximately 1.35 million people per year. The morbidity caused by trauma is also tremendous, leading to non-fatal injuries affecting the quality of life of approximately 20–30 million people around the world each year. Apart from this, the financial burden caused by trauma to countries is alarming accounting to 3% of the annual gross domestic product of the countries.[ 1 ]In India, during 2019, a total of 4,37,396 cases of 'Road Accidents' were reported which rendered 4,39,262 persons injured and 1,54,732 deaths as per national crime records bureau (NCRB).[ 2 ] Trauma can lead to morbidity, increased hospital stays, increased expenditure or even death. There is a need for a marker to predict the outcome of a patient early in the course. Despite medical advances, the task of risk stratification in patients with trauma remains challenging. Therefore, there is a need for a readily available method to categorise these patients. Studies have shown that total leucocyte count and red cell distribution width correlate with severity of injury independently. [ 3 – 6 ] In this study, we aim to correlate both red cell distribution width and total leucocyte count together with the outcome in terms of length of hospital stay in patients presenting with trauma. Materials And Methods We conducted a prospective observational study on 52 patients, who were selected according to inclusion and exclusion criteria and analysed in a level 1 trauma centre in Kolar, Karnataka. Complete blood picture within 24 hours of injury was collected and outcome measured in terms of length of hospital stay. Inclusion criteria: Trauma patients admitted in RLJH from November 2019 to April 2020. Exclusion criteria: Patients who require emergency surgery were excluded. Statistical analysis: Data was entered into Microsoft excel datasheet and was analysed using SPSS 22 version software. Categorical data was represented in the form of Frequencies and proportions. Continuous data was represented as mean and standard deviation. We used ANOVA test of significance as a test of significance to identify the mean difference between more than two quantitative variables. Correlations were performed with the Pearson Correlation coefficient P-value (Probability that the result is accurate) of <0.05 was considered as statistically significant after assuming all the rules of statistical tests. Statistical software: MS Excel , SPSS version 22 ( IBM SPSS Statistics, Somers NY, USA) was used to analyse data. Results Total of 52 patients were analysed prospectively, including 88.5% males and 11.5% females. Table 1 shows the distribution of study subjects across various age groups. Majority of the subjects 32.7% were in 21-30yrs age group followed by 23.1% of the subjects in 41-50yrs, 21.2% of the subjects in 31-40yrs, 11.5% of the subjects in 51-60yrs, 5.8% of subjects each in < 20yrs group and 61-70yrs age group. Table 1 Distribution of subjects according to age group. Age group N % < 20yrs 3 5.8 21-30yrs 17 32.7 31-40yrs 11 21.2 41-50yrs 12 23.1 51-60yrs 6 11.5 61-70yrs 3 5.8 Total 52 100.0 Mode of injury in the study population includes Road traffic accidents (RTA), penetrating stab injuries following alleged assaults. 80.8% of the subjects had RTA and 19.2% of the subjects had Stab. Descriptive statistics in Table 2 represents total leucocyte count, red cell distribution width and haemoglobin, which are measured at arrival within 24 hrs of injury along with the length of the patient's stay in hospital. Table 2 Descriptive statistics length of hospital stay, TLC, RDW, Hemoglobin Mean SD Length of hospital stay 11 6 TLC 12.9623 5.6121 RDW 13.3 1.2 Haemoglobin 13.0250 2.3911 Table 3 Mean length of hospital stay according to TLC and RDW. Length of hospital stay P-value Mean Standard Deviation TLC < 13 9 5 < 0.001 ≥ 13 14 6 RDW < 14 11 6 0.755 ≥ 14 12 5 The study subjects are divided based on the TLC and RDW values and the length of hospital stay was compared in the groups which are represented in Table.3 TLC ≥ 13 thousand/mm 3 and RDW ≥ 14% was taken as the cutoff. The mean length of hospital stay in patients with high TLC is significantly higher than in those with low TLC 14 \(\pm 6\) days vs 9 \(\pm\) 5 days; p<0.001. The mean length of hospital stay is slightly higher in patients with high RDW% than those with lo RDW% which is not statistically significant 12 \(\pm\) 5 days vs 11 \(\pm\) 6 days; p=0.755. Correlation of length of hospital stay was analysed for TLC, RDW and haemoglobin values in all the study subjects, which is shown in Table 4 . TLC had a positive correlation with the length of hospital stay, which was statistically significant and RDW had a positive correlation with the length of hospital stay, which was not statistically significant. The scatter plots of the correlations are represented in Figs. 1 , 2 and 3 . Table 4 Correlation of Length of hospital stay with TLC, RDW and Hemoglobin Length of hospital stay TLC Pearson Correlation 0.441 P value < 0.001 RDW Pearson Correlation 0.070 P-value 0.621 Haemoglobin Pearson Correlation -0.033 P value .832 Discussion Acute-phase response is an inevitable event following trauma, which is mediated by increased levels of inflammatory cytokines, catecholamines and corticosteroids. Post-traumatic leucocytosis is a well-known phenomenon but the mechanisms of which are controversial. There are various mechanisms described including the release of storage pool of neutrophils from the bone marrow, demargination of leucocytes. RDW represents the range of sizes of red blood cells. The association of high early TLC and severity of the head injury is well observed.[ 7 ] Various studies described controversial results on the association of early TLC and trauma with trauma including abdominal trauma, soft tissue injuries and traumatic brain injury.[ 3 – 6 ] Our institute being a trauma centre, we studied the correlation of early TLC and RDW done within 24 hrs of injury with the morbidity measured in terms of length of hospital stay. Majercik et al., in their study, found RDW as a useful marker of chronic health status in trauma patients.[ 8 ]. The use of RDW as a marker for acute conditions like the trauma is not studied much. In our study, we observed that the patients with high TLC and RDW turned out to stay longer in the hospitals. There is a positive correlation between length of hospital stay and total leucocyte count as well as red cell distribution width. Unlike the common belief that well-nourished patients with high haemoglobin may recover faster, haemoglobin at presentation does not correlate with the length of hospital stay in our study. There are limitations in the current study worth considering. The baseline pre-trauma RDW values of the patients were not considered as well as the chronic health status. The sample size is too small to analyse the efficacy of these markers as predictors for morbidity. Further major studies are required to analyse the efficacy. Conclusion TLC and RDW at presentation can be used as an adjunct in the prediction of higher morbidity along with other significant parameters in trauma patients. Though the correlation of RDW is not statistically significant, it is worth considering planning further studies in this aspect. Abbreviations TLC Total Leucocyte Count RDW Red Cell Distribtion Width Declarations Ethics approval and consent to participate Institutional ethical committee clearance was obtained prior to the start of the study. We obtained informed consent forms from all the subjects included. Ethical Clearance was taken from Institutional Ethics Committee, Sri Devaraj Urs Medical College. Consent for publication Consent was obtained from all the subjects involved in the study for publication of their data. Availability of data and materials The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request. Competing interests There is no conflict of interests among the authors for both financial and nonfinancial, Funding No funding was obtained. Authors' contributions BCM contributed to the design of the work, the acquisition of data, analysis, have drafted the work and substantively revised it. SPN contributed to the conception, design of the work, analysis, interpretation of data and substantively revised the manuscript. All the authors have approved the submitted version (and any substantially modified version that involves the author's contribution to the study); and have agreed both to be personally accountable for the author's own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature. Acknowledgements Not applicable Authors' information (optional) Dr BHAVANA CHOWDARY M Junior Resident, Department of Surgery, R L Jalappa Hospital and Research Centre, SDUAHER, Kolar, Karnataka. Dr SREERAMULU.P N Professor, Department of Surgery, R L Jalappa Hospital and Research Centre, SDUAHER, Kolar, Karnataka. References Global status report on road safety 2018. Geneva: World Health Organization; 2018. Licence: CC BYNC-SA 3.0 IGO. National Crime Records Bureau. Accidental Deaths & Suicides in India - 2019. New Delhi: National Crime Records Bureau (Ministry of Home Affairs); 2019 p. 120. Salehi S, Faridaalaee G, Mohammadi N. Salehi S, Faridaalaee G, Mohammadi N. Correlation of white blood cell count and severity of injury in abdominal trauma; a cross-sectional study. J Med Physiol. 2016;1(1):25-30. Santucci CA, Purcell TB, Mejia C. Leukocytosis as a predictor of severe injury in blunt trauma. West J Emerg Med. 2008;9(2):81-5. PMID: 19561712; PMCID: PMC2672249. Kong T, Park J, Park Y, Lee H, You J, Chung H et al. Usefulness of serial measurement of the red blood cell distribution width to predict 28-day mortality in patients with trauma. The American Journal of Emergency Medicine. 2017;35(12):1819-1827. Paulus EM, Weinberg JA, Magnotti LJ, Sharpe JP, Schroeppel TJ, Fabian TC, Croce MA. Admission red cell distribution width: a novel predictor of massive transfusion after injury. Am Surg. 2014 Jul;80(7):685-9. Rovlias A, Kotsou S. The blood leukocyte count and its prognostic significance in severe head injury. Surgical Neurology. 2001;55(4):190-196. Majercik S, Fox J, Knight S, Horne B. Red cell distribution width is predictive of mortality in trauma patients. Journal of Trauma and Acute Care Surgery. 2013;74(4):1021-1026. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-134788","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Original Research","associatedPublications":[],"authors":[{"id":6998954,"identity":"5d7c3d3d-5c45-4bc6-9cfe-791ce824e344","order_by":0,"name":"Bhavana Chowdary Madineni","email":"data:image/png;base64,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","orcid":"https://orcid.org/0000-0002-9983-6048","institution":"R L Jalappa Hospital and Research Centre","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Bhavana","middleName":"Chowdary","lastName":"Madineni","suffix":""},{"id":6998955,"identity":"b403410a-d5ae-4e00-bca2-69e1a009a591","order_by":1,"name":"Sreeramulu P N","email":"","orcid":"","institution":"R L JALAPPA HOSPITAL AND RESEARCH CENTRE, SDUAHER, KOLAR.","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Sreeramulu","middleName":"P","lastName":"N","suffix":""}],"badges":[],"createdAt":"2020-12-23 11:44:01","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-134788/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-134788/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":4554000,"identity":"94bca8b8-c34c-4e3e-9a1d-6f128edec96c","added_by":"auto","created_at":"2020-12-28 19:31:11","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":7742,"visible":true,"origin":"","legend":"Scatter plot of correlation between length of hospital stay and TLC ","description":"","filename":"Onlinefloatimage1.png","url":"https://assets-eu.researchsquare.com/files/rs-134788/v1/5eb9c4c95db629a19c8cfd6b.png"},{"id":4553815,"identity":"2bad3f5b-72f7-41b7-bbd3-b00dceee9765","added_by":"auto","created_at":"2020-12-28 19:28:11","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":7839,"visible":true,"origin":"","legend":"Scatter plot of correlation between length of hospital stay and RDW","description":"","filename":"Onlinefloatimage2.png","url":"https://assets-eu.researchsquare.com/files/rs-134788/v1/5e24c496d0e91b120d31b4fd.png"},{"id":4553999,"identity":"a7c26664-906a-416e-bf5f-61ecec20f2c1","added_by":"auto","created_at":"2020-12-28 19:31:11","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":7819,"visible":true,"origin":"","legend":"Scatter plot of correlation between length of hospital stay and Hemoglobin","description":"","filename":"Onlinefloatimage3.png","url":"https://assets-eu.researchsquare.com/files/rs-134788/v1/3f6593b9bb3efc312d79df1a.png"},{"id":13640481,"identity":"d98c2307-99c5-4e24-a9cf-b5e2512907b6","added_by":"auto","created_at":"2021-09-17 08:59:59","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":308770,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-134788/v1/c04fee35-b4e3-4bb7-9ddf-35922117fb78.pdf"}],"financialInterests":"","formattedTitle":"\u003cp\u003eCorrelation of Early Total Leucocyte Count and Red Cell Distribution Width With Outcome in Trauma\u003c/p\u003e","fulltext":[{"header":"Introduction","content":" \u003cp\u003eTrauma is any physical injury caused by a sudden or brief encounter with various levels of energy. The word 'trauma' comes from a Greek word which means 'wound'.The most common cause of trauma being road traffic accidents.\u003c/p\u003e \u003cp\u003eTrauma is the leading cause of death in children and young adults. Worldwide, it accounts for the death of approximately 1.35\u0026nbsp;million people per year. The morbidity caused by trauma is also tremendous, leading to non-fatal injuries affecting the quality of life of approximately 20\u0026ndash;30\u0026nbsp;million people around the world each year. Apart from this, the financial burden caused by trauma to countries is alarming accounting to 3% of the annual gross domestic product of the countries.[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]In India, during 2019, a total of 4,37,396 cases of 'Road Accidents' were reported which rendered 4,39,262 persons injured and 1,54,732 deaths as per national crime records bureau (NCRB).[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eTrauma can lead to morbidity, increased hospital stays, increased expenditure or even death. There is a need for a marker to predict the outcome of a patient early in the course. Despite medical advances, the task of risk stratification in patients with trauma remains challenging. Therefore, there is a need for a readily available method to categorise these patients.\u003c/p\u003e \u003cp\u003eStudies have shown that total leucocyte count and red cell distribution width correlate with severity of injury independently. [\u003cspan additionalcitationids=\"CR4 CR5\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e] In this study, we aim to correlate both red cell distribution width and total leucocyte count together with the outcome in terms of length of hospital stay in patients presenting with trauma.\u003c/p\u003e "},{"header":"Materials And Methods","content":"\u003cp\u003eWe conducted a prospective observational study on 52 patients, who were selected according to inclusion and exclusion criteria and analysed in a level 1 trauma centre in Kolar, Karnataka. Complete blood picture within 24 hours of injury was collected and outcome measured in terms of length of hospital stay.\u003c/p\u003e\n\u003cp\u003eInclusion criteria: Trauma patients admitted in RLJH from November 2019 to April 2020.\u003c/p\u003e\n\u003cp\u003eExclusion criteria: Patients who require emergency surgery were excluded.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical analysis:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData was entered into Microsoft excel datasheet and was analysed using SPSS 22 version software. Categorical data was represented in the form of Frequencies and proportions. Continuous data was represented as mean and standard deviation. \u003cstrong\u003eWe used ANOVA \u003c/strong\u003etest of significance as a test of significance to identify the mean difference between more than two quantitative variables. Correlations were performed with \u003cstrong\u003ethe Pearson Correlation coefficient\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eP-value\u003c/strong\u003e (Probability that the result is accurate) of \u0026lt;0.05 was considered as statistically significant after assuming all the rules of statistical tests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistical software:\u0026nbsp; \u003c/strong\u003eMS Excel\u003cstrong\u003e, \u003c/strong\u003eSPSS version 22\u003cstrong\u003e (\u003c/strong\u003eIBM SPSS Statistics, Somers NY, USA) was used to analyse data.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eTotal of 52 patients were analysed prospectively, including 88.5% males and 11.5% females. Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e shows the distribution of study subjects across various age groups. Majority of the subjects 32.7% were in 21-30yrs age group followed by 23.1% of the subjects in 41-50yrs, 21.2% of the subjects in 31-40yrs, 11.5% of the subjects in 51-60yrs, 5.8% of subjects each in \u0026lt;\u0026thinsp;20yrs group and 61-70yrs age group.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab1\" style=\"width: 50%;\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eDistribution of subjects according to age group.\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eAge group\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eN\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003e%\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;20yrs\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5.8\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e21-30yrs\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e17\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e32.7\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e31-40yrs\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e11\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e21.2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e41-50yrs\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e12\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e23.1\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e51-60yrs\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e11.5\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e61-70yrs\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e5.8\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTotal\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e52\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"char\" char=\".\"\u003e\n\u003cp\u003e100.0\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eMode of injury in the study population includes Road traffic accidents (RTA), penetrating stab injuries following alleged assaults. 80.8% of the subjects had RTA and 19.2% of the subjects had Stab.\u003c/p\u003e\n\u003cp\u003eDescriptive statistics in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e represents total leucocyte count, red cell distribution width and haemoglobin, which are measured at arrival within 24 hrs of injury along with the length of the patient's stay in hospital.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab2\" style=\"width: 50%;\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eDescriptive statistics length of hospital stay, TLC, RDW, Hemoglobin\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr\u003e\n\u003cth align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eMean\u003c/p\u003e\n\u003c/th\u003e\n\u003cth align=\"left\"\u003e\n\u003cp\u003eSD\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eLength of hospital stay\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e11\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e6\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eTLC\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e12.9623\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e5.6121\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eRDW\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e13.3\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e1.2\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003eHaemoglobin\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e13.0250\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd align=\"left\"\u003e\n\u003cp\u003e2.3911\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003c/div\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab3\" style=\"width: 50%;\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eMean length of hospital stay according to TLC and RDW.\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003ctbody\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" colspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eLength of hospital stay\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 70px;\" rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eP-value\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\u0026nbsp;\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003eMean\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003eStandard Deviation\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 70px;\" rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eTLC\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;13\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e9\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e5\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 70px;\" rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e\u003cspan class=\"Underline\"\u003e\u0026ge;\u003c/span\u003e\u0026thinsp;13\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e14\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e6\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 70px;\" rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eRDW\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;14\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e11\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e6\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 70px;\" rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003e0.755\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e\u003cspan class=\"Underline\"\u003e\u0026ge;\u003c/span\u003e\u0026thinsp;14\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e12\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e5\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e\n\u003cp\u003eThe study subjects are divided based on the TLC and RDW values and the length of hospital stay was compared in the groups which are represented in Table.3 TLC\u0026thinsp;\u003cspan class=\"Underline\"\u003e\u0026ge;\u003c/span\u003e\u0026thinsp;13 thousand/mm\u003csup\u003e3\u003c/sup\u003e and RDW\u0026thinsp;\u003cspan class=\"Underline\"\u003e\u0026ge;\u003c/span\u003e\u0026thinsp;14% was taken as the cutoff. The mean length of hospital stay in patients with high TLC is significantly higher than in those with low TLC 14\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\pm 6\\)\u003c/span\u003e\u003c/span\u003e days vs 9\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\pm\\)\u003c/span\u003e\u003c/span\u003e5 days; p\u0026lt;0.001. The mean length of hospital stay is slightly higher in patients with high RDW% than those with lo RDW% which is not statistically significant 12\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\pm\\)\u003c/span\u003e\u003c/span\u003e5 days vs 11\u003cspan class=\"InlineEquation\"\u003e\u003cspan class=\"mathinline\"\u003e\\(\\pm\\)\u003c/span\u003e\u003c/span\u003e6 days; p=0.755.\u003c/p\u003e\n\u003cp\u003eCorrelation of length of hospital stay was analysed for TLC, RDW and haemoglobin values in all the study subjects, which is shown in Table\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e4\u003c/span\u003e. TLC had a positive correlation with the length of hospital stay, which was statistically significant and RDW had a positive correlation with the length of hospital stay, which was not statistically significant. The scatter plots of the correlations are represented in Figs.\u0026nbsp;\u003cspan class=\"InternalRef\"\u003e1\u003c/span\u003e,\u003cspan class=\"InternalRef\"\u003e2\u003c/span\u003e and \u003cspan class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e\n\u003cdiv class=\"gridtable\"\u003e\n\u003ctable id=\"Tab4\" style=\"width: 50%;\" border=\"1\"\u003e\u003ccaption\u003e\n\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\n\u003cdiv class=\"CaptionContent\"\u003e\n\u003cp\u003eCorrelation of Length of hospital stay with TLC, RDW and Hemoglobin\u003c/p\u003e\n\u003c/div\u003e\n\u003c/caption\u003e\n\u003cthead\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003cth style=\"height: 35px;\" align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth style=\"height: 35px;\" align=\"left\"\u003e\u0026nbsp;\u003c/th\u003e\n\u003cth style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003eLength of hospital stay\u003c/p\u003e\n\u003c/th\u003e\n\u003c/tr\u003e\n\u003c/thead\u003e\n\u003ctbody\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 70px;\" rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eTLC\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003ePearson Correlation\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.441\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003eP value\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 70px;\" rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eRDW\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003ePearson Correlation\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.070\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003eP-value\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e0.621\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 70px;\" rowspan=\"2\" align=\"left\"\u003e\n\u003cp\u003eHaemoglobin\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003ePearson Correlation\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"char\" char=\".\"\u003e\n\u003cp\u003e-0.033\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 35px;\"\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003eP value\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"height: 35px;\" align=\"left\"\u003e\n\u003cp\u003e.832\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003c/div\u003e"},{"header":"Discussion","content":" \u003cp\u003eAcute-phase response is an inevitable event following trauma, which is mediated by increased levels of inflammatory cytokines, catecholamines and corticosteroids. Post-traumatic leucocytosis is a well-known phenomenon but the mechanisms of which are controversial. There are various mechanisms described including the release of storage pool of neutrophils from the bone marrow, demargination of leucocytes. RDW represents the range of sizes of red blood cells.\u003c/p\u003e \u003cp\u003eThe association of high early TLC and severity of the head injury is well observed.[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] Various studies described controversial results on the association of early TLC and trauma with trauma including abdominal trauma, soft tissue injuries and traumatic brain injury.[\u003cspan additionalcitationids=\"CR4 CR5\" citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e] Our institute being a trauma centre, we studied the correlation of early TLC and RDW done within 24 hrs of injury with the morbidity measured in terms of length of hospital stay.\u003c/p\u003e \u003cp\u003eMajercik et al., in their study, found RDW as a useful marker of chronic health status in trauma patients.[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. The use of RDW as a marker for acute conditions like the trauma is not studied much. In our study, we observed that the patients with high TLC and RDW turned out to stay longer in the hospitals. There is a positive correlation between length of hospital stay and total leucocyte count as well as red cell distribution width. Unlike the common belief that well-nourished patients with high haemoglobin may recover faster, haemoglobin at presentation does not correlate with the length of hospital stay in our study.\u003c/p\u003e \u003cp\u003eThere are limitations in the current study worth considering. The baseline pre-trauma RDW values of the patients were not considered as well as the chronic health status. The sample size is too small to analyse the efficacy of these markers as predictors for morbidity. Further major studies are required to analyse the efficacy.\u003c/p\u003e "},{"header":"Conclusion","content":" \u003cp\u003eTLC and RDW at presentation can be used as an adjunct in the prediction of higher morbidity along with other significant parameters in trauma patients. Though the correlation of RDW is not statistically significant, it is worth considering planning further studies in this aspect.\u003c/p\u003e "},{"header":"Abbreviations","content":"\u003cp\u003eTLC Total Leucocyte Count\u003c/p\u003e\n\u003cp\u003eRDW Red Cell Distribtion Width\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInstitutional ethical committee clearance was obtained prior to the start of the study. We obtained informed consent forms from all the subjects included.\u003c/p\u003e\n\u003cp\u003eEthical Clearance was taken from Institutional Ethics Committee, Sri Devaraj Urs Medical College.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eConsent was obtained from all the subjects involved in the study for publication of their data.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere is no conflict of interests among the authors for both financial and nonfinancial,\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNo funding was obtained.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBCM contributed to the design of the work,\u0026nbsp;the acquisition of data, analysis, have drafted the work and substantively revised it. SPN contributed to the conception, design of the work,\u0026nbsp;analysis,\u0026nbsp;interpretation of data and substantively revised the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAll the authors \u003c/strong\u003ehave approved the submitted version (and any substantially modified version that involves the author's contribution to the study); and\u0026nbsp;have agreed both to be personally accountable for the author's own contributions and to ensure that questions related to the accuracy or integrity of any part of the work, even ones in which the author was not personally involved, are appropriately investigated, resolved, and the resolution documented in the literature.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors' information (optional)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDr BHAVANA CHOWDARY M\u003c/p\u003e\n\u003cp\u003eJunior Resident, Department of Surgery, R L Jalappa Hospital and Research Centre, SDUAHER, Kolar, Karnataka.\u003c/p\u003e\n\u003cp\u003eDr SREERAMULU.P N\u003c/p\u003e\n\u003cp\u003eProfessor, Department of Surgery, R L Jalappa Hospital and Research Centre, SDUAHER, Kolar, Karnataka.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eGlobal status report on road safety 2018. Geneva: World Health Organization; 2018. Licence: CC BYNC-SA 3.0 IGO.\u003c/li\u003e\n\u003cli\u003eNational Crime Records Bureau. Accidental Deaths \u0026amp; Suicides in India - 2019. New Delhi: National Crime Records Bureau (Ministry of Home Affairs); 2019 p. 120.\u003c/li\u003e\n\u003cli\u003eSalehi S, Faridaalaee G, Mohammadi N. Salehi S, Faridaalaee G, Mohammadi N. Correlation of white blood cell count and severity of injury in abdominal trauma; a cross-sectional study. J Med Physiol. 2016;1(1):25-30.\u003c/li\u003e\n\u003cli\u003eSantucci CA, Purcell TB, Mejia C. Leukocytosis as a predictor of severe injury in blunt trauma. West J Emerg Med. 2008;9(2):81-5. PMID: 19561712; PMCID: PMC2672249.\u003c/li\u003e\n\u003cli\u003eKong T, Park J, Park Y, Lee H, You J, Chung H et al. Usefulness of serial measurement of the red blood cell distribution width to predict 28-day mortality in patients with trauma. The American Journal of Emergency Medicine. 2017;35(12):1819-1827.\u003c/li\u003e\n\u003cli\u003ePaulus EM, Weinberg JA, Magnotti LJ, Sharpe JP, Schroeppel TJ, Fabian TC, Croce MA. Admission red cell distribution width: a novel predictor of massive transfusion after injury. Am Surg. 2014 Jul;80(7):685-9.\u003c/li\u003e\n\u003cli\u003eRovlias A, Kotsou S. The blood leukocyte count and its prognostic significance in severe head injury. Surgical Neurology. 2001;55(4):190-196.\u003c/li\u003e\n\u003cli\u003eMajercik S, Fox J, Knight S, Horne B. Red cell distribution width is predictive of mortality in trauma patients. Journal of Trauma and Acute Care Surgery. 2013;74(4):1021-1026.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Injuries, polytrauma, blood cell count, leucocytosis, red cell indices","lastPublishedDoi":"10.21203/rs.3.rs-134788/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-134788/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eTrauma is the leading cause of death in young adults. Risk stratification in patients with trauma remains challenging. There is a need for a readily available prognostic method to categorise these patients.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eAims \u0026amp; Objectives:\u003c/strong\u003e We aim to measure and correlate red cell distribution width and total leucocyte count in patients presenting with trauma within 24 hours of injury with the outcome.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eWe included 52 trauma patients who were admitted in RLJH from November 2019 to April 2020, who did not require emergency surgery and analysed prospectively. Complete blood picture within 24 hours of injury was analysed and outcome measured in terms of length of hospital stay. \u003c/p\u003e\u003cp\u003e\u003cstrong\u003eResults: \u003c/strong\u003eThere was a statistically significant correlation found between TLC and Length of hospital stay (p\u0026lt;0.001). The correlation between RDW and Length of hospital stay was not statistically significant. The analysis showed that increased hospital stay was associated with high TLC and RDW% done within 24 hours of injury. \u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eTLC and RDW can be used as readily available and simple markers in early prediction of higher morbidity in patients presenting with trauma.\u003c/p\u003e","manuscriptTitle":"Correlation of Early Total Leucocyte Count and Red Cell Distribution Width With Outcome in Trauma","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2020-12-28 19:28:09","doi":"10.21203/rs.3.rs-134788/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"4b0b6e3a-150b-4b41-817f-d36f7de72cc1","owner":[],"postedDate":"December 28th, 2020","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":1641853,"name":"Critical Care \u0026 Emergency Medicine"}],"tags":[],"updatedAt":"2020-12-28T19:31:11+00:00","versionOfRecord":[],"versionCreatedAt":"2020-12-28 19:28:09","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-134788","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-134788","identity":"rs-134788","version":["v1"]},"buildId":"rHA-KDH7Qsr4HCuvH75dn","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}