Acute Traumatic Coagulopathy

2003/06/01 by Karim Brohi, Jasmin Singh, Mischa Heron +2 · 1,732 citations
Medicine · #Abdominal Trauma and Injuries #Anesthesia #Coagulopathy #Emergency medicine #Hemostasis and retained surgical items #Hypothermia #Incidence (geometry) #Injury Severity Score #Injury prevention #Internal medicine #Medicine #Poison control #Retrospective cohort study #Surgery #Trauma, Hemostasis, Coagulopathy, Resuscitation #Traumatic brain injury

paper · doi:10.1097/01.ta.0000069184.82147.06

published in The Journal of Trauma: Injury, Infection, and Critical Care 54(6), 1127-1130 (Lippincott Williams & Wilkins)

openalex publication_date 2003/06/01 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/30

Abstract

BACKGROUND: Traumatic coagulopathy is thought to be caused primarily by fluid administration and hypothermia. METHODS: A retrospective study was performed to determine whether coagulopathy resulting from the injury itself is a clinically important entity in severely injured patients. RESULTS: One thousand eight hundred sixty-seven consecutive trauma patients were reviewed, of whom 1,088 had full data sets. Median Injury Severity Score was 20, and 57.7% had an Injury Severity Score > 15; 24.4% of patients had a significant coagulopathy. Patients with an acute coagulopathy had significantly higher mortality (46.0% vs. 10.9%; chi2, p < 0.001). The incidence of coagulopathy increased with severity of injury, but was not related to the volume of intravenous fluid administered (r2 = 0.25, p < 0.001). CONCLUSION: There is a common and clinically important acute traumatic coagulopathy that is not related to fluid administration. This is a marker of injury severity and is related to mortality. A coagulation screen is an important early test in severely injured patients.

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