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. 2012 Nov 14:12:16.
doi: 10.1186/1471-227X-12-16.

Acute traumatic coagulopathy among major trauma patients in an urban tertiary hospital in sub Saharan Africa

Erick Mujuni  1 , Robert Wangoda, Peter Ongom, Moses Galukande
Affiliations

Acute traumatic coagulopathy among major trauma patients in an urban tertiary hospital in sub Saharan Africa

Erick Mujuni et al. BMC Emerg Med. .

Abstract

Background: Mortality from trauma remains a major public health issue as it is the leading cause of death in persons aged 5 to 44 years. Uncontrolled hemorrhage and coagulopathy is responsible for over 50% of all trauma related deaths within the first 48 hrs of admission. Coagulation profiles are not routinely done among trauma patients in resource limited settings and there is a paucity of data on acute traumatic coagulopathy (ATC) in sub Saharan Africa. The study was conducted to evaluate the prothrombin time and partial thromboplastin time (PT/PTT) as predictors of mortality and morbidity among major trauma patients.

Methods: A prospective cohort study was carried out, in which major trauma patients admitted in A&E department between December 2011 to April 2012 were recruited. Five (5) mls of venous blood was drawn from a convenient vein within 10 minutes of the patient's arrival at A&E for analysis of PT/PTT. Patients were stratified into two groups by the presence/absence of coagulopathy then followed up for a 2 week period for morbidity and mortality.

Results: A total of 182 major trauma patients were recruited; 149 (81.9%) were males, the mean age was 29.5 years (SD 9.8). Prevalence of coagulopathy was 54% (98/182). The mean ISS for the ATC group was 36.9 and the non ATC group was 26.9 (p=0.001). Patients with ATC stayed longer in hospital 11.24 days than non ATC patients 8 days (p=0.001). ATC was strongly associated with ARI (p= 0.003). Mortality was more in the ATC group 29 deaths compared to 9 deaths in the non ATC group. PTT was a strong independent predictor of mortality.

Conclusion: A significant proportion of major trauma patients were coagulopathic. Initial coagulation profile is useful in predicting outcomes for major trauma patients.

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Figures

Figure 1
Figure 1
Probability of survival in the study population for PT.
Figure 2
Figure 2
Probability of survival in the study population for aPTT.
See this image and copyright information in PMC

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