Coagulation abnormalities in traumatic shock

✍ Scribed by Gary J Ordog; Jonathan Wasserberger; Subramaniam Balasubramanium

• Publisher: Elsevier Science
• Year: 1985
• Tongue: English
• Weight: 548 KB
• Volume: 14
• Category: Article
• ISSN: 1097-6760
• DOI: 10.1016/s0196-0644(85)80881-7

✦ Synopsis

Coagulation abnormalities can pose a threat to hemorrhaging patients and to attempts at surgical correction. We have shown that 97.2% of our 180 patients who died of trauma had evidence of coagulation defects prior to fluid or blood treatment. Twelve of 180 patients could not be cross-matched due to inability of their blood to coagulate in the tube. Clinically 50% of these patients had excessive oozing from venipuncture sites, and 28% had excessive hematoma formation not associated with vascular injury. The most frequently abnormal test was the prothrombin time, in 97% of patients followed by platelet count in 72%, and partial thromboplastin time in 70%. The greatest degree of coagulation abnormality occurred in patients with head trauma, followed in decreasing order by gunshot wounds, blunt trauma, and stab wounds to the body. Because 97.2% of the patients had abnormal coagulation studies prior to fluid and blood replacement, this abnormality most likely was due to disseminated intravascular coagulation. We propose using the tube-clot test to give a rapid indication of coagulation in traumatized patients while awaiting laboratory test results.