Abstract Number: PB0296
Meeting: ISTH 2020 Congress
Background: Trauma-Induced Coagulopathy (TIC) affects nearly 1 in 4 patients after major trauma. Post-traumatic bleeding is still the leading cause of death among trauma patients. The appropriate strategy for the management of trauma-induced coagulopathy is still a matter of debate.
Aims: The main purpose of the study was to characterise traditional screening coagulation tests and Point-of-Care (POC) profiles of each patient at time of admission to the Emergency Department of Padua University Hospital for major trauma.
Methods: Adult trauma patients (≥16 years) with “major trauma” according to Padua triage scoring system admitted to the Emergency Department of Padua University Hospital were considered eligible for the study. For each patient the characteristics of anamnesis and triage were collected at admission. Vital signs, Focus Assessment with Sonography for Trauma (EcoFAST), arterial blood gas, routine screening coagulation tests and ROTEM profile were also evaluated and trauma scores were calculated.
Results: 33 patients, predominantly males (73%), with a mean age of 49 years old were enrolled. Thirty-day mortality rate was 12%. ROTEM profiles described a hypocoagulable state in patients with ISS ≥ 16: CFTINTEM was significantly prolonged (p=0,025) and MCFEXTEM significantly reduced (p=0,020). We also found a negative correlation between CTEXTEM and PT (r= -0,65, p< 0,001); a direct correlation between CTINTEM and aPTT (r= 0,80, p< 0,001); a direct correlation between A10 EXTEM and PT (r=0,49, p=0,007); and finally a negative correlation between A10 INTEM and aPTT (r= -0,85, p< 0,001).
Conclusions: Our data show a hypocoagulable trend in both patients with the most severe trauma and those who died within 30 day. The present study, although preliminary, proves that POC methods may provide rapid (10-15 minutes) and consistent information about the patient’s coagulation state. Larger multicentre studies are needed to confirm our results.
To cite this abstract in AMA style:Spiezia L, Casarotto M, Simion C, Campello E, Simioni P. Whole Blood Coagulation Profiles at the Time of Emergency Unit Admission in Patients with Major Trauma [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/whole-blood-coagulation-profiles-at-the-time-of-emergency-unit-admission-in-patients-with-major-trauma/. Accessed November 27, 2021.
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