+ Site Statistics
References:
54,258,434
Abstracts:
29,560,870
PMIDs:
28,072,757
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Risk factors and clinical significance of trauma-induced coagulopathy in ICU patients with severe trauma



Risk factors and clinical significance of trauma-induced coagulopathy in ICU patients with severe trauma



European Journal of Emergency Medicine 20(4): 286-290



To investigate the incidence and risk factors for trauma-induced coagulopathy (TIC) and the impact of TIC on outcomes of patients with severe trauma admitted to an emergency intensive care unit. We retrospectively reviewed clinical data from 223 patients with severe trauma admitted to emergency intensive care unit within 24 h after injury. Injury Severity Score (ISS), Acute Physiology and Chronic Health Evaluation II score, coagulation function, routine blood and biochemical tests, and blood gas parameters were obtained from medical records. Patients were divided into two groups according to the presence or absence of coagulopathy. ISS, Acute Physiology and Chronic Health Evaluation II score, and the incidence rates of hypothermia and tissue hypoperfusion were compared. The risk factors of TIC were analyzed and a multivariate logistic regression equation was developed. Coagulation function and the incidence of TIC were also compared between surviving and dead patients. Overall, 52/223 (23.3%) patients fulfilled the diagnostic criteria for TIC. Their mortality rate was significantly higher than that of patients without coagulopathy (36.5 vs. 9.4%, P<0.01). ISS, incidence rates of hypothermia and tissue hypoperfusion, and the prevalence of severe traumatic brain injury were significantly higher (P<0.01), whereas Glasgow Coma Scale, hemoglobin, hematocrit, and platelet counts were significantly lower (P<0.01) in patients with coagulopathy than those without. Base deficit at least 6, Glasgow Coma Scale 8 or less, and platelet count were independent risk factors for TIC. Compared with surviving patients, the patients who died had significantly reduced coagulation function. The incidence of TIC is particularly high among patients with severe trauma. TIC is associated with increased ISS, brain injury, shock and hypothermia, and mortality.

(PDF emailed within 0-6 h: $19.90)

Accession: 055579036

Download citation: RISBibTeXText

PMID: 22976461

DOI: 10.1097/MEJ.0b013e328358bec7


Related references

Risk factors for trauma-induced coagulopathy- and transfusion-associated multiple organ failure in severely injured trauma patients. Frontiers in Medicine 2: 24, 2015

Prehospital identification of trauma patients with early acute coagulopathy and massive bleeding: results of a prospective non-interventional clinical trial evaluating the Trauma Induced Coagulopathy Clinical Score (TICCS). Critical Care 18(6): 648, 2015

Prehospital identification of trauma patients requiring transfusion: results of a retrospective study evaluating the use of the trauma induced coagulopathy clinical score (TICCS) in 33,385 patients from the TraumaRegister DGU ®. Acta Chirurgica Belgica 117(6): 385-390, 2017

Case scenario: management of trauma-induced coagulopathy in a severe blunt trauma patient. Anesthesiology 119(1): 191-200, 2013

Prevalence and impact of abnormal ROTEM(R) assays in severe blunt trauma: results of the 'Diagnosis and Treatment of Trauma-Induced Coagulopathy (DIA-TRE-TIC) study'. British Journal of Anaesthesia 107(3): 378-387, 2011

How do external factors contribute to the hypocoagulative state in trauma-induced coagulopathy? - In vitro analysis of the lethal triad in trauma. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 26(1): 66, 2018

Comparison of Disseminated Intravascular Coagulation DIC in Trauma with Coagulopathy of Trauma/Acute Coagulopathy of Trauma-Shock COT/ACOTS. 2012

Thromboelastography (TEG) and rotational thromboelastometry (ROTEM) for trauma induced coagulopathy in adult trauma patients with bleeding. Cochrane Database of Systematic Reviews 2015(2): Cd010438, 2015

Comparison of disseminated intravascular coagulation in trauma with coagulopathy of trauma/acute coagulopathy of trauma-shock. Journal of Thrombosis and Haemostasis 10(12): 2593-2595, 2013

Influence of surgical bleeding on the relationship between admission coagulopathy and risk of massive transfusion: lesson from 704 severe trauma patients. Vox Sanguinis 111(2): 151-160, 2017

Correlation between coagulopathy and outcome in severe head trauma in neurointensive care and trauma units. Journal of Critical Care 26(4): 352-356, 2011

Analysis of clinical risk factors associated with the prognosis of severe multiple-trauma patients with acute lung injury. Journal of Emergency Medicine 43(3): 407-412, 2013

The prognostic significance of thoracic and abdominal trauma in severe trauma patients (Injury severity score > 15). Annali Italiani di Chirurgia 81(3): 171-176, 2010

Trauma-induced coagulopathy: standard coagulation tests, biomarkers of coagulopathy, and endothelial damage in patients with traumatic brain injury. Journal of Neurotrauma 30(4): 301-306, 2013

Differentiating disseminated intravascular coagulation (DIC) with the fibrinolytic phenotype from coagulopathy of trauma and acute coagulopathy of trauma-shock (COT/ACOTS). Journal of Thrombosis and Haemostasis 11(5): 826-835, 2014