Evaluation of coagulopathy frequency and risk factors in trauma patients in intensive care unit

Abstract

Background: Post traumatic coagulopathy is a frequently encountered problem. However, risk factors related to coagulopathy are not exactly known. Objectives: In this study it is targeted to determine the frequency of coagulopathy related to trauma, risk factors and its affect to prognosis on patients admitted to Intensive Care Unit(ICU) after trauma retrospectively. Methods: 184 patients admitted to mixed type adult ICU, which is having 20 beds, in the years between 2011 and 2017 due to trauma have been studied. Patients have been separated into two groups as patients having coagulopathy and not having coagulopathy by examining their laboratory results. Patients having; thrombocyte count <100 000/μL on the first and third days, Prothrombin Time(PT)>16s, activated Partial Thromboplastine Time(aPTT)>40s, International Normalized Ratio(INR)>1.6 are being accepted as having coagulopathy. Medical records of patients have been recorded retrospectively. Results: The average age of 184 patients that are included in the study is 41.77; 19% of them are Female and 81% of them are Male. Coagulopathy detected on 78 patients (42.4%) (on the first day 32.6%, on the third day 9.8%). It has been detected that, patients developed coagulopathy were having more accompanying diseases(p<0.05), lower Glasgow Coma Score (GCS)(p<0.05), lower albumin values(p<0.05) and higher 28-day mortality rates(p<0.001) compared to patients that have not developed coagulopathy. Revised Trauma Score(RTS) of two groups are not significant(p>0.05). Having accompanying diseases, having low GCS and albumin values are being determined as independent risk factors in coagulopathy development. Conclusion: As a conclusion; since it is not possible to change GCS and risk factors belong to critical trauma patients, we think that it is possible to decrease the frequency of coagulopathy development as well as mortality rate by preventing risk factors such as hypoalbuminemia by means of suitable approaches.