Evidence Browser: Source: BrohiEtAl2003

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Publication:Acute traumatic coagulopathy
Reference:

Brohi, K. Singh, J. Heron, M. Coats, T. 2003, "Acute Traumatic Coagulopathy", J Trauma, 54(6), 1127-1130

Abstract:Background: Traumatic coagulopathy is thought to be caused primarily by fluid administration and hypothermia. Methods: A retrospective study was performed to determine whether coagulopathy resulting from the injury itself is a clinically important entity in severely injured patients. Results: One thousand eight hundred sixty-seven consecutive trauma patients were reviewed, of whom 1,088 had full data sets. Median Injury Severity Score was 20, and 57.7% had an Injury Severity Score > 15; 24.4% of patients had a significant coagulopathy. Patients with an acute coagulopathy had significantly higher mortality (46.0% vs. 10.9%; chi2, p < 0.001). The incidence of coagulopathy increased with severity of injury, but was not related to the volume of intravenous fluid administered (r2 = 0.25, p < 0.001). Conclusion: There is a common and clinically important acute traumatic coagulopathy that is not related to fluid administration. This is a marker of injury severity and is related to mortality. A coagulation screen is an important early test in severely injured patients.
Publication Type:Human observational study
Low Risk of Bias:
  • Causative factors defined
  • Causative factors measured accurately
  • Coagulopathy appropriately defined
  • Coagulopathy assessed on arrival to hospital
  • Eligibility criteria
  • Representative sample from a relevant population
High Risk of Bias:
  • Adjustment for confounding
  • All eligible patients included
  • Baseline characteristics of sample
Risk of Bias Score:6