The DOI matches its Crossref record; 14 of the 14 references it cites were found in a registry or an index.
Predicting Life-threatening Coagulopathy in the Massively Transfused Trauma Patient: Hypothermia and Acidoses Revisited
Abstract
BACKGROUND: Recalcitrant coagulopathy "the bloody vicious cycle," produces the majority of deaths after torso trauma. A model predicting this life-threatening complication may facilitate clinical decision-making. METHODS: We prospectively analyzed patients > 15 years old who received a massive transfusion (> 10 units of packed red blood cells (PRBC)/24 h) over a 2-year period. Excluding massive head injuries and pre-existing disease, the 58 study patients had a mean age = 35.4 years, Injury Severity Score (ISS) = 30.6, and PRBC = 24.2 units/24 h. RESULTS: Defined as prothrombin time of two times that of normal laboratory controls and partial thromboplastin time as two times that of normal laboratory controls, 27 patients (47%) developed life-threatening coagulopathy. Using a multiple logistic regression model, the four significant risk factors (with odds ratio) were (1) pH < 7.10 (12.3), (2) temperature < 34 degrees C (8.7), (3) ISS > 25 (7.7), and (4) systolic blood pressure < 70 mm Hg (5.8). The conditional probability of developing coagulopathy was ISS > 25 + systolic blood pressure < 70 mm Hg = 39%, ISS > 25 + temperature < 34 degrees C = 49%, ISS > 25 + pH < 7.10 = 49%; with all four risk factors the incidence was 98%. CONCLUSION: Postinjury life-threatening coagulopathy in the seriously injured requiring massive transfusion is predicted by persistent hypothermia and progressive metabolic acidosis.
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Self-citationThe Staged Celiotomy for Trauma Issues in Unpacking and Reconstruction
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Self-citationHemostasis in Massively Transfused Trauma Patients
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Hypothermia and acidosis worsen coagulopathy in the patient requiring massive transfusion
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Cited by
Damage Control Resuscitation: Directly Addressing the Early Coagulopathy of Trauma
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The Coagulopathy of Trauma: A Review of Mechanisms
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Management of bleeding following major trauma: a European guideline
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Stinger, H. K., Spinella, P. C., Perkins, J. G., Grathwohl, K. W., Salinas, J., Martini, W. Z., Hess, J. R., Dubick, M. A., Simon, C. D., Beekley, A. C., et al. (2008) · Journal of Trauma: Injury, Infection & Critical Care · doi:10.1097/ta.0b013e318160a57b · Cited by 414
Definition and drivers of acute traumatic coagulopathy: clinical and experimental investigations
FRITH, D., GOSLINGS, J. C., GAARDER, C., MAEGELE, M., COHEN, M. J., ALLARD, S., JOHANSSON, P. I., STANWORTH, S., THIEMERMANN, C., & BROHI, K. (2010) · Journal of Thrombosis and Haemostasis · doi:10.1111/j.1538-7836.2010.03945.x · Cited by 401
Metadata
- Authors
- Cosgriff, N., Moore, E. E., Sauaia, A., Kenny-Moynihan, M., Burch, J. M., & Galloway, B.
- Venue
- The Journal of Trauma: Injury, Infection, and Critical Care
- Published
- 1997-05
- Volume
- 42
- Issue
- 5
- Pages
- 857-862
- ISSN
- 1079-6061
- OpenAlex
- W2082479261
- Cited by
- 655
- References
- 14
- FWCI
- 11.03
- Type
- journal article
- Language
- en
- Open access
- closed
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