Clinical study of hypothermia, acidosis and coagulopathy in the patients with multiple trauma

Abstract

Objective To observe the incidence of hypothermia, acidosis and coagulopathy in the patients with multiple trauma and to explore the potential relationship among them. Methods A retrospective study was carried out to observe the incidences of hypothermia, acidosis, coagulopathy and shock from a database of 713 trauma patients consisting of 184 simple trauma patients and 529 multiple trauma patients. Moreover, the multiple trauma patients were classified into critical multiple trauma subgroup (CMT) , severe multiple trauma subgroup (SMT) and mild multiple trauma subgroup (MMT) by using injury severity score. The potential relationships among shock and hypothermia, acidosis, coagulopathy were analyzed. Results Analysis of data from the database indicated that the incidences of hypothermia, acidosis, coagulopathy and lethal triad in multiple trauma patients were 8.1%, 18.9%, 27.6% and 7.8%, respectively, which were significantly higher compared with simple trauma patients (P <0.05, P < 0.01) . As increase in disease severity, the incidence of lethal triad was significantly higher in CMT subgroup (11.1%) compared with SMT subgroup (7.1%) and MMT subgroup (2.0%) (P <0.05) . Multiple trauma patients, particularly with hypovolaemic shock, tended to have higher incidence of hypothermia, acidosis and coagulopathy (P <0.01) . Conclusion Our study demonstrates the high incidences of hypothermia, acidosis and coagulopathy are prominent in the patients with multiple trauma. Moreover, post-traumatic shock is the major factor to induce the occurrence of hypothermia, acidosis, coagulopathy and triad of death in the patients with multiple trauma. Key words: Multiple trauma; Hypothermia; Acidosis; Coagulopathy