J Korean Soc Traumatol.  2012 Sep;25(3):72-78.

Acute Traumatic Coagulopathy in Severe Trauma Patients

• Lee DE
• Seo KS
• Lee MJ
• Shin SJ
• Ryoo HW
• Kim JK
• Park JB

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.

Keyword

Trauma; Coagulopathy; Outcome; Prediction

MeSH Terms

Aged
Emergencies
Humans
Injury Severity Score
Liver
Logistic Models
Male
Resuscitation
Retrospective Studies
Shock