From: Thrombelastography and biomarker profiles in acute coagulopathy of trauma: a prospective study
ISS > 26 | ISS 15-26 | ISS < 15 | p-value | |||
---|---|---|---|---|---|---|
Demography, injury severity, transfusion and mortality | ||||||
N | 23 | 26 | 30 | |||
Age | yrs | 45 (25-71) | 57 (43-65) | 42 (28-49) | 0.034 | c |
Gender | m% (n) | 74% (17) | 62% (16) | 67% (20) | NS | |
Blunt trauma | % (n) | 96% (22) | 96% (25) | 83% (25) | 0.142 | |
ISS | score | 34 (29-36) | 22 (17-25) | 9 (5-10) | NA | |
sTBI | % (n) | 17% (4) | 46% (12) | 29% (6) | 0.091 | |
GCS (PH) | score | 7 (3-13) | 11 (6-15) | 15 (12-15) | 0.002 | a |
Crystalloids (PH) | ml | 900 (250-1250) | 275 (0-500) | 250 (25-750) | 0.013 | a, b |
RBC 0-24 h | units | 2 (0-12) | 1 (0-3) | 0 (0-1) | 0.007 | a |
FFP 0-24 h | units | 2 (0-9) | 0 (0-1) | 0 (0-0) | 0.003 | a |
PLT 0-24 h | units | 0 (0-4) | 0 (0-0) | 0 (0-0) | 0.006 | a |
MT (> 10 RBC in 24 h) | % (n) | 35% (8) | 4% (1) | 3% (1) | 0.001 | a, b |
Mortality | % (n) | 39% (9) | 15% (4) | 3% (1) | 0.003 | a |
Shock, sympathoadrenal activation, cell damage, biochemistry and hemostasis | ||||||
SBP (PH) | mmHg | 150 (108-156) | 136 (125-152) | 130 (123-143) | NS | |
pH | 7.31 (7.25-7.33) | 7.40 (7.307.40) | 7.37 (7.33-7.41) | 0.001 | a, b | |
Lactate | mmol/l | 1.7 (1.2-2.2) | 2.5 (1.3-3.1) | 1.5 (0.9-2.1) | 0.049 | c |
SBE | mmol/l | -3.6 (-5.7- -1.9) | -2.7 (-4.6- -0.5) | -1.0 (-1.8-0.7) | 0.005 | a |
Adrenaline | pg/ml | 1,062 (328-1,549) | 292 (126-1,077) | 247 (86-354) | 0.002 | a |
Noradrenaline | pg/ml | 1,235 (434-1,511) | 652 (210-1,288) | 332 (217-1,036) | 0.040 | a |
hcDNA | % | 16.9 (5.6-27.0) | 5.6 (2.4-10.3) | 0.4 (0.0-9.3) | <0.001 | a |
Hemoglobin | mmol/l | 8.0 (6.3-9.2) | 8.6 (7.2-9.1) | 8.4 (7.7-8.9) | NS | |
Platelet count | 109/l | 217 (165-252) | 193 (173-260) | 211 (191-240) | NS | |
Fibrinogen | g/l | 2.0 (1.4-2.2) | 2.4 (2.1-2.9) | 2.6 (2.3-2.9) | 0.002 | a, b |
FXIII | microg/ml | 25 (20-30) | 30 (22-40) | 32 (28-41) | 0.001 | a |
vWF | % | 190 (110-218) | 200 (132-223) | 204 (146-230) | NS | |
APTT > 35 sec | % | 22% (5) | 4% (1) | 0% | 0.009 | a |
INR > 1.2 | % | 43% (10) | 0% | 0% | <0.001 | a, b |
Thrombelastography | ||||||
R | min | 5.1 (4.8-5.9) | 5.9 (5.1-6.7) | 6.0 (5.3-6.4) | 0.046 | |
Angle | degrees | 65 (62-68) | 67 (62-7) | 66 (62-70) | NS | |
MA | mm | 63 (58-67) | 64 (62-68) | 63 (61-67) | NS | |
Ly30 | % | 0.2 (0.0-0.7) | 0.0 (0.0-0.2) | 0.3 (0.0-1.0) | 0.040 | |
Platelet activation and thrombin generation | ||||||
sCD40L | pg/ml | 394 (281-551) | 327 (251-406) | 250 (195-305) | 0.006 | a |
PF1.2 | nmol/l | 4.1 (1.1-13.0) | 15.1 (4.1-45.3) | 4.2 (1.6-9.5) | 0.026 | b, c |
TAT | ng/ml | 36 (32-41) | 39 (33-44) | 35 (29-40) | 0.181 | |
Natural anticoagulation | ||||||
AT | 103 U/l | 0.89 (0.69-0.96) | 0.9 (0.8-1.00) | 0.98 (0.90-1.07) | 0.002 | a |
PC | % | 92 (75-116) | 107 (96-123) | 117 (100-129) | 0.031 | a |
APC | ng/ml | 10.4 (9.4-12.1) | 10.5 (8.7-13.5) | 8.0 (6.8-10.5) | 0.005 | a, c |
TFPI | ng/ml | 64 (48-86) | 67 (52-80) | 54 (41-74) | NS | |
Fibrinolysis | ||||||
D-dimer | ng/ml | 173 (172-176) | 170 (144-175) | 128 (36-148) | <0.001 | a, c |
tPA | ng/ml | 7.3 (5.5-15.4) | 7.8 (4.7-13.7) | 5.2 (2.0-9.9) | 0.063 | |
PAI-1 | ng/ml | 24 (11-37) | 31 (14-68) | 20 (13-27) | 0.145 | |
PAP | ng/ml | 316 (22-599) | 475 (83-1152) | 225 (54-393) | 0.159 |