Abstract
Background : Despite improvement in many aspects of acute trauma care, uncontrolled bleeding is responsible for more than 50% of all trauma related deaths within the first two days of admission. Objective : This study sought to determine the incidence of coagulopathy among major trauma patients and their associated outcome. Methods : A prospective descriptive study carried at KNH among major trauma patients. Coagulation status was determined within 30 minutes of arrival. Outcomes assessed included length of hospital stay, transfusion requirement and mortality for 30 days. Fischer’s exact test was used to analyze categorical variables and Student T test used to analyze continuous variables. Results : Majority (85.7%) of the 140 patients recruited were male and, the mean age was 29.4 years (SD=12.0). Coagulopathy was present in 52.1% of the patients. The mean ISS on admission was 23.3 (SD=4.8), patients with coagulopathy had a higher ISS 22.2 (SD=5.2, p=0.018). The patients with coagulopathy stayed longer in hospital 12 days and their mortality was higher 21 (95.5%) p<0.001. Conclusion : Majority of trauma patients were coagulopathic. Initial assessment of coagulation status in trauma patients is useful in planning care and anticipating complications. Key words : Coagulopathy, Major trauma, Incidence, Outcomes, Low and middle income countries
Highlights
Uncontrolled bleeding accounts for more than half of all trauma related deaths within the first 2 days of admission [1]
It has been shown that more patients have abnormal prothrombin time (PT) than partial thromboplastin time (PTT) [5]
Most studies have evaluated coagulopathy among all trauma patients including minor trauma while this study only looked at major trauma patients
Summary
Uncontrolled bleeding accounts for more than half of all trauma related deaths within the first 2 days of admission [1]. Identifying patients who are at risk of developing acute coagulopathy of trauma and their aggressive management has been shown to reduce trauma associated morbidity and mortality [5]. No study has documented local prevalence of coagulopathy in patient with major trauma. Despite improvement in many aspects of acute trauma care, uncontrolled bleeding is responsible for more than 50% of all trauma related deaths within the first two days of admission. Objective: This study sought to determine the incidence of coagulopathy among major trauma patients and their associated outcome. Outcomes assessed included length of hospital stay, transfusion requirement and mortality for 30 days. The patients with coagulopathy stayed longer in hospital 12 days and their mortality was higher 21 (95.5%) p
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