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The prevalence of abnormal results of conventional coagulation tests on admission to a trauma center
Author(s) -
Hess John R.,
Lindell Allison L.,
Stansbury Lynn G.,
Dutton Richard P.,
Scalea Thomas M.
Publication year - 2009
Publication title -
transfusion
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.045
H-Index - 132
eISSN - 1537-2995
pISSN - 0041-1132
DOI - 10.1111/j.1537-2995.2008.01944.x
Subject(s) - medicine , partial thromboplastin time , trauma center , coagulation testing , prothrombin time , injury severity score , resuscitation , major trauma , coagulopathy , disseminated intravascular coagulation , coagulation , emergency medicine , surgery , poison control , injury prevention , retrospective cohort study
BACKGROUND: Several groups have reported that a fraction of severely injured patients have abnormal coagulation tests at presentation to trauma centers, even in the absence of significant crystalloid resuscitation. These patients have high mortality, but their prevalence in trauma populations is not clear from the reports. STUDY DESIGN AND METHODS: Records of all patients admitted to a large urban trauma center during 2000 through 2006 were searched for early measures of common coagulation tests and in‐hospital mortality. RESULTS: Abnormal coagulation tests were increasingly frequent with increasing injury severity, ranging from 5 to 43 percent for the prothrombin time as the injury severity scores (ISSs) increased from 5 to more than 45 and 4 to 18 percent for platelet counts of less than 150 × 10 9 per L. Abnormal coagulation tests were associated with excess mortality even below conventional transfusion triggers and this was especially true for the partial thromboplastin time. CONCLUSIONS: Abnormal coagulation tests are common in severely injured patients. Even in the moderately injured, they are associated with higher mortality.