%0 Journal Article
%T Reduced clot strength upon admission, evaluated by thrombelastography (TEG), in trauma patients is independently associated with increased 30-day mortality
%A Kristin B Nystrup
%A Nis A Windel£¿v
%A Annemarie B Thomsen
%A P£¿r I Johansson
%J Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
%D 2011
%I BioMed Central
%R 10.1186/1757-7241-19-52
%X A retrospective study of trauma patients with an injury severity qualifying them for inclusion in the European Trauma Audit and Research Network (TARN) and a TEG analysis performed upon arrival at the trauma centre.Eighty-nine patients were included. The mean Injury Severity Score (ISS) was 21 with a 30-day mortality of 17%. Patients with a reduced clot strength (maximal amplitude < 50 mm) evaluated by TEG, presented with a higher ISS 27 (95% CI, 20-34) vs. 19 (95% CI, 17-22), p = 0.006 than the rest of the cohort. Clot strength correlated with the amount of packed red blood cells (p = 0.01), fresh frozen plasma (p = 0.04) and platelet concentrates (p = 0.03) transfused during the first 24 hours of admission. Patients with low clot strength demonstrated increased 30-day mortality (47% vs. 10%, p < 0.001). By logistic regression analysis reduced clot strength was an independent predictor of increased mortality after adjusting for age and ISS.Low clot strength upon admission is independently associated with increased 30-day mortality in trauma patients and it could be speculated that targeted interventions based on the result of the TEG analysis may improve patient outcome. Prospective randomized trials investigating this potential are highly warranted.Exsanguination due to uncontrolled bleeding is the leading cause of potentially preventable deaths among trauma patients [1-3]. Upon arrival at the hospital, about one third of all trauma patients present with coagulopathy [4-6], which is associated with increased transfusion requirements, development of multi organ failure and death [5-7]. The presence of coagulopathy will aggravate active hemorrhaging in traumatized patients.Coagulopathy associated with traumatic injury has historically been described as the result of multiple environmental factors such as acidemia and hypothermia, which have been shown to independently impair blood clotting [4,7,8]. Combined with dilution and consumption of coagulation factors and pl
%K thrombelastography
%K trauma
%K coagulopathy
%K transfusion
%U http://www.sjtrem.com/content/19/1/52