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Acute Traumatic Coagulopathy
Abstract
BACKGROUND: Traumatic coagulopathy is thought to be caused primarily by fluid administration and hypothermia. METHODS: A retrospective study was performed to determine whether coagulopathy resulting from the injury itself is a clinically important entity in severely injured patients. RESULTS: One thousand eight hundred sixty-seven consecutive trauma patients were reviewed, of whom 1,088 had full data sets. Median Injury Severity Score was 20, and 57.7% had an Injury Severity Score > 15; 24.4% of patients had a significant coagulopathy. Patients with an acute coagulopathy had significantly higher mortality (46.0% vs. 10.9%; chi2, p < 0.001). The incidence of coagulopathy increased with severity of injury, but was not related to the volume of intravenous fluid administered (r2 = 0.25, p < 0.001). CONCLUSION: There is a common and clinically important acute traumatic coagulopathy that is not related to fluid administration. This is a marker of injury severity and is related to mortality. A coagulation screen is an important early test in severely injured patients.
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Cited by
Gonzalez, E., Moore, E. E., Moore, H. B., Chapman, M. P., Chin, T. L., Ghasabyan, A., Wohlauer, M. V., Barnett, C. C., Bensard, D. D., Biffl, W. L., et al. (2016) · Annals of Surgery · doi:10.1097/sla.0000000000001608 · Cited by 641
The Relationship of Blood Product Ratio to Mortality: Survival Benefit or Survival Bias?
Snyder, C. W., Weinberg, J. A., McGwin, G., Melton, S. M., George, R. L., Reiff, D. A., Cross, J. M., Hubbard-Brown, J., Rue, L. W., & Kerby, J. D. (2009) · Journal of Trauma: Injury, Infection & Critical Care · doi:10.1097/ta.0b013e318196c3ac · Cited by 384
Evaluation of rotation thrombelastography for the diagnosis of hyperfibrinolysis in trauma patients
Levrat, A., Gros, A., Rugeri, L., Inaba, K., Floccard, B., Negrier, C., & David, J.-S. (2008) · British Journal of Anaesthesia · doi:10.1093/bja/aen083 · Cited by 331
Pathophysiology and Treatment of Coagulopathy in Massive Hemorrhage and Hemodilution
Bolliger, D., Görlinger, K., Tanaka, K. A., & Warner, D. S. (2010) · Anesthesiology · doi:10.1097/aln.0b013e3181f22b5a · Cited by 325
Antifibrinolytic drugs for acute traumatic injury
Ker, K., Roberts, I., Shakur, H., & Coats, T. J. (2015) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd004896.pub4 · Cited by 320
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Metadata
- Authors
- Brohi, K., Singh, J., Heron, M., & Coats, T.
- Venue
- The Journal of Trauma: Injury, Infection, and Critical Care
- Published
- 2003-06
- Volume
- 54
- Issue
- 6
- Pages
- 1127-1130
- ISSN
- 0022-5282 (ISSN-L)
- OpenAlex
- W1992034786
- Cited by
- 1,726
- References
- 0
- FWCI
- 11.71
- Type
- journal article
- Language
- en
- Open access
- closed
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- Brohi, K., Singh, J., Heron, M., & Coats, T. (2003). Acute Traumatic Coagulopathy. The Journal of Trauma: Injury, Infection, and Critical Care. https://doi.org/10.1097/01.ta.0000069184.82147.06
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