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)

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


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.

aOnly patients with normal or hypercoagulable TEG MA were compared (Wilcoxon Rank Sum tests or Chi-square/Fischer exact tests, as appropriate) but data are presented on the two patients that displayed hypocoagulability (MA < 51 mm) and hypocoagulable hyperfibrinolysis (MA < 51 mm and Ly30 > 8%).

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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