Acute Traumatic Coagulopathy in Severe Trauma Patients

Lee,  Dong Eun; Seo,  Kang Suk; Lee,  Mi Jin; Shin,  Su Jeong; Ryoo,  Hyun Wook; Kim,  Jong Kun; Park,  Jung Bae

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Original Article

Journal of the Korean Society of Traumatology 2012;25(3):72-78.

Acute Traumatic Coagulopathy in Severe Trauma Patients

Dong Eun Lee, Kang Suk Seo, Mi Jin Lee, Su Jeong Shin, Hyun Wook Ryoo, Jong Kun Kim, Jung Bae Park

Department of Emergency Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea. kssuh@knu.ac.kr

중증 외상환자의 급성 외상응고장애 조기 예측인자 분석

이동언ㆍ서강석ㆍ이미진ㆍ신수정ㆍ류현욱ㆍ김종근ㆍ박정배

경북대학교 의학전문대학원 응급의학교실

Received: 20 August 2012 • Revised: 28 August 2012 • Accepted: 10 September 2012

Abstract

PURPOSE
Clinical observation and research findings show that acute traumatic coagulopathy (ATC) is a major factor that must be addressed in the early care of severe trauma patients. ATC is associated with increased transfusion requirements and poor clinical outcomes. This study aimed to correlate the early predictable factors of ATC with the outcomes in severe trauma patients.
METHODS
Retrospective data from the trauma registry on severe trauma patients (Injury Severity Score (ISS)> or =16) were used to identify variables independently associated with coagulopathy. Univariate associations were calculated, and a multivariable logistic regression analysis was used to determine variables independently associated with ATC.
RESULTS
Patients were mostly male, aged 51.9+/-17.8 years, with an injury severity score of 24.1+/-12.4. ATC, as diagnosed in the emergency department (ED), occurred in 17% of the severe trauma patients. Using a multivariable logistic regression analysis, early predictable variables independently associated with ATC were base deficit (odds ratio (OR): 13.03; 95% confidence interval (CI): 3.47-48.93), acute liver injury (OR: 4.24; 95% CI: 1.06-17.00), and transfer from another hospital (OR: 21.00; 95% CI: 3.23-136.60).
CONCLUSION
ATC is associated with mortality in severe trauma patients, and some variables associated with trauma and shock are an independent predictors of ATC. These variables contribute to the early recognition and management of coagulopathy, which may improve the outcome from trauma resuscitation.

Key Words: Trauma; Coagulopathy; Outcome; Prediction

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