Study of Coagulation Profile in Patients Admitted to a Trauma Center in a Tertiary Care Hospital

Abstract

CONTEXT: Globally, trauma is the leading cause of death in young adult population, with approximately accounting for 10% of all deaths. Trauma-induced coagulopathy (TIC) is an independent predictor of morbidity and mortality. AIMS: The aim of the study was to find the prevalence of abnormal test results of coagulation on admission to a trauma center and correlate them with mortality. SETTINGS AND DESIGN: This was a cross-sectional observational study conducted on patients admitted to a trauma center of a tertiary care hospital. SUBJECTS AND METHODS: A total of 149 patients with an Injury Severity Score >15 were included in the study. Blood samples of the patients were collected within 24 h of trauma and 2 h of admission and tested for platelet (PLT) count, prothrombin time (PT), activated partial thromboplastin time (APTT), and fibrinogen (FIB) level. The patients were stratified into two groups – presence/absence of TIC and followed for 2 weeks for mortality. STATISTICAL ANALYSIS USED: Data analysis was done using Microsoft Excel and statistics software SPSS 20 version. RESULTS: Among the 149 patients, 84 had TIC, out of which 71.43% of the patients showed mortality. Of the remaining patients who had no TIC, 35.38% reported mortality. If all the four parameters, that is, PT, APTT, FIB, and PLTs, were considered together, then the percentage of mortality increased to 89.47%. If PT and APTT were studied together, then the percentage of mortality increased to 85.71%. If PT, APTT, and FIB were studied together, the mortality was 84.62%, whereas for parameters PT, APTT, and PLTs together, the mortality was 80%. CONCLUSIONS: Coagulopathy is a strong predictor of mortality in major trauma patients. Basic coagulation tests appear to be sensitive tools for identifying patients at high risk of early death and can be used for early minute diagnosis of TIC. Patients with TIC should be managed aggressively to prevent mortality.