Incidence and Early Outcome of Coagulopathy among Major Trauma Patients

Abstract

Background: Despite improvement in many aspects of acute trauma care, uncontrolled bleeding is responsible for more than 50% of all trauma related deaths within the first two days of admission. Objective: This study sought to determine the incidence of coagulopathy among major trauma patients and their associated outcome. Methods: A prospective descriptive study carried at KNH among major trauma patients. Coagulation status was determined within 30 minutes of arrival. Outcomes assessed included length of hospital stay, transfusion requirement and mortality for 30 days. Fischer’s exact test was used to analyze categorical variables and Student T test used to analyze continuous variables. Results: The majority (85.7%) of the 140 patients recruited were male and, the mean age was 29.4 years (SD=12.0). Coagulopathy was present in 52.1% of the patients. The mean ISS on admission was 23.3 (SD=4.8), patients with coagulopathy had a higher ISS 22.2 (SD=5.2, p=0.018). The patients with coagulopathy stayed longer in hospital 12 days and their mortality was higher 21 (95.5%) p<0.001. Conclusion: The majority of trauma patients were coagulopathic. Initial assessment of coagulation status in trauma patients is useful in planning care and anticipating complications.

Keywords

• coagulopathy
• major trauma
• incidence
• outcomes
• low and middle income countries