Table 2 Demography, injury severity, transfusion requirements, mortality, biochemistry and hemostasis, thrombelastography and biomarkers of coagulopathy in 80 trauma patients stratified according to TEG profile (normal, hypercoagulability, hypocoagulability, hyperfibrinolysis)
From: Thrombelastography and biomarker profiles in acute coagulopathy of trauma: a prospective study
Normal | Hyper- coagulable | Hypo- coagulable | Hyper- fibrinolysis | p-valuea | ||
|---|---|---|---|---|---|---|
(51-69 mm) | (> 69 mm) | (< 51 mm) | (< 51 mm/> 8%) | |||
Demography, injury severity, transfusion and mortality | ||||||
N | 69 | 9 | 1 | 1 | ||
Age | yrs | 44 (32-58) | 72 (59-80) | 63 | 80 | 0.006 |
Gender | m% (n) | 68% (47) | 56% (5) | 100% | 100% | NS |
Blunt trauma | % (n) | 90% (62) | 100% | 100% | 100% | NS |
ISS | score | 18 (10-29) | 17 (16-20) | 25 | 50 | NS |
sTBI | % (n) | 30% (18) | 33% (3) | 100% | 0% | NS |
GCS (PH) | score | 13 (6-15) | 12 (9-14) | 7 | 6 | NS |
Crystalloids (PH) | ml | 300 (0-1000) | 500 (200-500) | 0 | 500 | NS |
RBC 0-24 h | units | 0 (0-4) | 0 (0-1) | 0 | 45 | NS |
FFP 0-24 h | units | 0 (0-3) | 0 (0-0) | 0 | 36 | NS |
PLT 0-24 h | units | 0 (0-1) | 0 (0-0) | 0 | 15 | NS |
MT (> 10 RBC in 24 h) | % (n) | 14% (10) | 0% | 0% | 100% | 0.159 |
Mortality | % (n) | 16% (11) | 22% (2) | 0% | 100% | NS |
Shock, sympathoadrenal activation, cell damage, biochemistry and hemostasis | ||||||
SBP (PH) | mmHg | 135 (122-149) | 129 (100-153) | 170 | 95 | NS |
pH | 7.34 (7.29-7.38) | 7.37 (7.31-7.41) | 7.38 | 7.06 | NS | |
Lactate | mmol/l | 1.9 (1.4-2.9) | 2.3 (1.4-2.8) | 1.3 | 8.4 | NS |
SBE | mmol/l | -2.1 (-4.1--0.2) | 0.3 (-2.0-0.7) | -1.9 | -10.7 | 0.127 |
Adrenaline | pg/ml | 295 (112-976) | 1,163 (191-1,471) | 298 | 5,427 | 0.169 |
Noradrenaline | pg/ml | 638 (276-1,307) | 1,146 (120-2,540) | 731 | 549 | NS |
HcDNA | % | 4.7 (0.1-13.5) | 10.0 (7.2-16.4) | 9.8 | 17.1 | 0.126 |
Hemoblobin | mmol/l | 8.4 (7.6-9.1) | 7.5 (6.5-8.8) | 8.8 | 6.4 | NS |
Platelet count | 109/l | 206 (173-251) | 275 (185-306) | 117 | 172 | 0.045 |
Fibrinogen | g/l | 2.3 (2.0-2.7) | 3.1 (3.0-3.4) | 1.1 | 1.1 | < 0.001 |
FXIII | microg/ml | 29 (24-36) | 37 (29-43) | 21 | 18 | 0.096 |
vWF | % | 200 (127-225) | 190 (151-222) | 124 | 203 | NS |
APTT > 35 sec | % (n) | 7% (5) | 0% | 0% | 100% | NS |
INR > 1.2 | % (n) | 13% (9) | 0% | 0% | 100% | 0.134 |
Thrombelastography | ||||||
R | min | 5.6 (4.9-6.4) | 5.4 (5.1-5.7) | 6.7 | 6.1 | NS |
Angle | degrees | 65 (62-69) | 70 (67-73) | 41 | 54 | 0.027 |
MA | mm | 63 (61-66) | 71 (69-73) | 49 | 33 | NA |
Ly30 | % | 0.2 (0.0-0.6) | 0.0 (0.0-0.0) | 0 | 78 | 0.076 |
Platelet activation and thrombin generation | ||||||
sCD40L | pg/ml | 292 (223-417) | 332 (263-406) | 399 | 1,431 | NS |
PF1.2 | nmol/l | 6.6 (2.7-18.0) | 4.5 (1.0-22.4) | 1.0 | 0.4 | NS |
TAT | ng/ml | 37 (31-43) | 36 (31-44) | 29 | 38 | NS |
Natural anticoagulation | ||||||
AT | 103 U/l | 0.92 (0.82-1.02) | 0.95 (0.88-0.98) | 0.98 | 0.61 | NS |
PC | % | 108 (91-124) | 108 (100-135) | 138 | 71 | NS |
APC | ng/ml | 9.8 (7.6-12.1) | 9.3 (9.1-11.1) | 13.7 | 10.3 | NS |
TFPI | ng/ml | 58 (44-78) | 78 (57-84) | 126 | 68 | 0.075 |
Fibrinolysis | ||||||
D-dimer | ng/ml | 166 (122-173) | 170 (141-174) | 179 | 173 | NS |
tPA | ng/ml | 6.9 (3.6-12.0) | 12.1 (5.8-14.8) | 2.6 | 25.4 | 0.123 |
PAI-1 | ng/ml | 22 (12-38) | 33 (24-68) | 8 | 24 | NS |
PAP | ng/ml | 283 (45-619) | 510 (331-1154) | 0 | 316 | 0.126 |