PMID: 9191667May 1, 1997Paper

Predicting life-threatening coagulopathy in the massively transfused trauma patient: hypothermia and acidoses revisited

The Journal of Trauma
N CosgriffB Galloway

Abstract

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. 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. 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%. Postinjury life-threatening coagu...Continue Reading

References

Jul 1, 1979·Annals of Surgery·R B CountsC J Carrico
Jan 1, 1978·American Journal of Surgery·A J Walt
Jun 1, 1976·The Journal of Trauma·C E Lucas, A M Ledgerwood
May 11, 1992·Annals of Surgery·J M BurchG L Jordan
Nov 1, 1990·American Journal of Surgery·A FerraraM A McMillen
Oct 1, 1989·The Journal of Trauma·C HarriganA M Ledgerwood
Aug 1, 1988·The Surgical Clinics of North America·A PattE E Moore
Jul 1, 1973·The Journal of Trauma·R C LimF W Blaisdell
Nov 1, 1971·Annals of Surgery·R D MillerS L Barton
May 1, 1983·Annals of Surgery·H H StoneR J Mullins
Aug 1, 1982·The Journal of Trauma·J L KashukJ B Moore
Apr 1, 1981·The Journal of Trauma·D V FelicianoG L Jordan
Sep 1, 1994·The Journal of Trauma·T D JohnstonR L Reed
Jan 1, 1993·Journal of Clinical Epidemiology·D L SimelD B Matchar
May 1, 1993·Annals of Surgery·J A MorrisK W Sharp
Jun 1, 1996·The Journal of Trauma·J R GarrisonR L Fulton
May 1, 1996·World Journal of Surgery·A SauaiaD C Lezotte

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Citations

Apr 6, 2004·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Jean-François HardyUNKNOWN Groupe d'intérêt en Hémostase Périopératoire
Jun 13, 2006·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Jean-François HardyUNKNOWN Members of the Groupe d'Intérêt en Hémostase Périopératoire
Oct 14, 2004·Der Anaesthesist·D FriesP Innerhofer
Jan 16, 2007·Der Anaesthesist·O GrottkeR Rossaint
Feb 1, 2007·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·O Grottke, R Rossaint
Oct 12, 2012·Aesthetic Plastic Surgery·Luís Ricardo Martinhão SoutoJoyce Maria Annichino Bizzacchi
Mar 4, 2011·Langenbeck's Archives of Surgery·Christian KleberNorbert P Haas
Mar 13, 2010·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Katherine MorganDavid B Adams
Sep 10, 2013·Journal of Visceral Surgery·C Arvieux, J Abba
Jan 20, 2004·Injury·Betty J Tsuei, Paul A Kearney
Oct 16, 2002·Thrombosis Research·Peter Hellstern, Hannelore Haubelt
Jul 26, 2003·Transfusion Medicine Reviews·Ray Armand, John R Hess
Oct 23, 2003·Transfusion Medicine Reviews·Irina Bakaltcheva, Thomas Reid
Jun 8, 1999·Journal of the American College of Surgeons·R Y Peng, F S Bongard
Aug 9, 2008·Journal of Neurotrauma·Casey H HalpernSherman C Stein
Aug 10, 2002·The Journal of Trauma·Steven N VaslefMark W Sebastian
Oct 24, 2001·Pediatric Emergency Care·J F HolmesN Kuppermann
May 25, 2007·Critical Care Medicine·Carl-Erik Dempfle, Martin Borggrefe
Mar 14, 2003·The Journal of Trauma·Asher HirshbergKenneth L Mattox
Jul 12, 2003·The Journal of Trauma·Jana B A MacLeodMary Murtha
Dec 17, 2003·The Journal of Trauma·James W SuliburkRao R Ivatury
May 28, 2005·The Journal of Trauma·Wenjun Z MartiniJohn B Holcomb
Dec 24, 2005·The Journal of Trauma·Eric M AchesonJohn B Holcomb
Jun 10, 2006·The Journal of Trauma·Lloyd KetchumSeppo Hiippala
Jun 10, 2006·The Journal of Trauma·John R Hess, Jeffrey H Lawson
Jul 13, 2006·The Journal of Trauma·Wenjun Z MartiniJohn B Holcomb
Jun 13, 2006·The Journal of Trauma·Nedim YücelUNKNOWN Polytrauma Study Group of the German Trauma Society
Jul 13, 2006·The Journal of Trauma·David S KauvarJohn R Hess
Sep 13, 2006·The Journal of Trauma·Martin EngströmPeter Reinstrup
Jan 12, 2007·The Journal of Trauma·Ernest A GonzalezBruce A McKinley

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