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Journal of Trauma and Injury 2014;27(4):158-164.
The Effect of Acute Coagulopathy in Profoundly Traumatic Patients on Acute and Early Deaths
Minsu Noh, Song Soo Yang, Kyu Hyouck Kyoung
1Department of Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
2Department of Trauma Center, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea. traumacrew@uuh.ulsan.kr
3Department of Emergency Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.
고도 중증외상 환자에서 급성 혈액응고장애가 초기 및 조기 사망에 미치는 영향
노민수, 양성수, 경규혁1,2
울산대학교 의과대학 울산대학교병원 외과학교실, 1권역외상센터, 2응급의학교실
Received: 14 September 2014   • Revised: 21 October 2014   • Accepted: 22 October 2014
Numerous studies have investigated the pattern of traumatic death with a focus on the injury mechanism, the severity of the injury and the presence of hemorrhage. Acute coagulopathy has been treated as only one of many complications. The purpose of this study was to investigate the influence of acute coagulopathy on acute and early death due to trauma.
A retrospective analysis of trauma patients with injury severity score (ISS)> or =25 who had been treated between January 2011 and December 2012 was conducted. Based on the time of injury, traumatic death was categorized into acute (within 48 hours) and early (from 3 to 7 days). The correlations between various parameters within 24 hours after injury and time of death were analyzed.
A total of 124 patients were enrolled. Of them, 8.1% (n=10) of the patients experienced acute mortality. For those patients, significant differences in initial systolic blood pressure, coagulopathy score, amount of transfusion, abbreviated injury scale of the head and neck, the abdomen and the extremities were noted. Early mortality was experienced by 7.0% (n=8) of the patients, only coagulopathy score was found to be a significant independent risk factor for acute (odds ratio: 3.127; 95% confidence interval: 1.185-8.252; p=0.021) and early mortality (odds ratio: 2.470; 95% confidence interval: 1.029-5.929; p=0.043).
Acute traumatic coagulopathy has an important role in the mortality, even after the acute phase. Early management and prevention of acute coagulopathy may improve survival of trauma patients.
Key Words: Trauma; Coagulopathy; Mortality


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