Table 1

Demography, injury severity, transfusion requirements, mortality, biochemistry and hemostasis, thrombelastography and biomarkers of coagulopathy in 80 trauma patients stratified according to injury severity score (ISS)

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


Data are presented as medians (IQR) or n (%), with p-values shown for variables with p < 0.200, and in bold for p < 0.050. ISS groups were compared by Kruskal-Wallis and Bonferroni adjusted Wilcoxon Rank Sum post hoc tests, Wilcoxon Rank Sum tests and Chi-square/Fischer exact tests, as appropriate.

aISS gr. 0 (ISS < 15) vs. 2 (ISS > 26) Bonferroni adjusted p < 0.05; bISS gr. 1 (ISS 15-26) vs. 2 (ISS > 26) Bonferroni adjusted p < 0.05; cISS gr. 0 (ISS < 15) vs. 1 (ISS 15-26) Bonferroni adjusted p < 0.05.

ISS, injury severity score; sTBI, severe Traumatic Brain Injury, Abbreviated Injury Score head > 3; PH, pre-hospital at the site of injury; GCS, Glascow Coma Score scale; RBC, red blood cells; FFP, fresh frozen plasma; PLT, platelet concentrates; MT, > 10 RBC the initial 24 hours; SBP, systolic blood pressure; APTT, activated partial thromboplastin time; INR, international normalized ratio. Biomarker abbreviations, see Materials and Methods section, ELISA.

Ostrowski et al. Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine 2011 19:64   doi:10.1186/1757-7241-19-64

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