Abstract 231: Difference of the Trauma-Induced Coagulopathy Between Penetrating and Blunt Trauma

Abstract

Introduction: The trauma-induced coagulopathy is well-known pathophysiology of severely injured trauma patients. However, the difference due to the injury type is not well researched. The aim of this study is to investigate the difference of coagulopathy between the blunt and penetrating trauma. PATIENTS and Methods: Single-center retrospective study was conducted. The electrical record of patients admitted from April 2008 to March 2017 were reviewed and penetrating trauma patients with injury severity score (ISS) 9 or more were enrolled. The case-control matching with blunt trauma patients was performed, adjusting for ISS, Shock-Index, the need for transfusion, and lactate level at the hospital arrival. After the matching, 5 points of hemoglobin, fibrinogen, platelet, prothrombin-time percentage (PT%), fibrin/fibrinogen degradation products (FDP), and D-dimer in their clinical course were statistically compared. Results: 8 patients were matched. FDP at hospital arrival was significantly higher in the blunt group compared to the penetrating group (Median 7.85 vs 92.8; p<0.01). Although there is no statistical significance, in the blunt group, D-dimer of the acute phase was much higher and PT% of the early phase was much lower than that of the penetrating group (refer the figures). Conclusion: In the acute and early phase of severe traumatic injury, the hyperfibrinolysis of blunt trauma can be significantly more severe than that of penetrating trauma.