Acute traumatic coagulopathy
J Trauma. 2003 Jun;54(6):1127-30. doi: 10.1097/01.TA.0000069184.82147.06.
Karim Brohi 1 , Jasmin Singh, Mischa Heron, Timothy Coats
1 Trauma and Critical Care Unit, Royal London Hospital, United Kingdom. karim@trauma.org
DOI: 10.1097/01.TA.0000069184.82147.06
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.
Acute Disease
Blood Coagulation Disorders / epidemiology*
Emergency Medical Services / statistics & numerical data
Fluid Therapy / statistics & numerical data
London / epidemiology
Multiple Trauma / classification
Multiple Trauma / epidemiology*
Wounds, Nonpenetrating / epidemiology