Analysis of risk factors and prognosis of acute traumatic coagulopathy in patients with polytrauma

Abstract

Objective To analyze the risk factors and the prognostic factors of acute traumatic coagulopathy(TC) in patients with polytrauma. Methods The clinical data of 180 patients with multiple trauma were analyzed.All the patients were divided into TC group and control group according to whether acute TC was occurring or not.The TC group were divided into death group and survival group according to the prognosis.The influence of age, gender, multiple trauma cause, blood index[hemoglobin(Hb), hematocrit(Hct), platelet(Plt)], coagulation index[prothrombin time(PT), activated partial thromboplastin time(APTT)], arterial blood gas index, injury severity score(ISS), acute physiology and chronic health score Ⅱ(APACHE Ⅱ), Glasgow Coma Scale(GCS) score, complicated with severe head injury(STBI), blood transfusion, use of antihypertensive drugs on TC and prognosis were analyzed. Results There were 52 patients with TC in 180 patients with polytrauma, which accounted for 28.89%.There were 21 deaths in 52 patients with TC, which accounted for 40.38%.There were 12 deaths in 128 patients without TC, which accounted for 9.38%.The death rate of the TC patients were significantly higher than that of the non-TC patients, the difference was statistically significant(χ2=23.749, P<0.01). The differences of the ratio of Consolidate STBI, the ratio of using boost drugs, GCS≤6, Hb, Hct, Plt, ISS, APACHE Ⅱ, blood transfusion between the TC group and control group were statistically significant(χ2=45.779, 28.281, 15.626, t=5.148, 6.183, 13.366, 6.248, 9.146, 8.353, all P<0.01). logistic regression analysis showed that GCS≤6 points, complicated with STBI, Plt count were independent risk factors for acute TC in patients with polytrauma. Conclusion Emergency patients with multiple injuries are prone to TC, which has higher mortality.The GCS≤6 points, complicated with STBI and Plt count are the independent risk factors for TC.The GCS≤6 points, complicated with STBI are the independent risk factors for prognosis of TC patients. Key words: Multiple trauma; Traumatic coagulopathy; Prognosis; Factor analysis, statistical