Author(s): Brohi K, Singh J, Heron M, Coats T
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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.
This article was published in J Trauma
and referenced in Journal of Blood Disorders & Transfusion