tailieunhanh - Báo cáo y học: "Reduced clot strength upon admission, evaluated by thrombelastography (TEG), in trauma patients is independently associated with increased 30-day mortality"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Reduced clot strength upon admission, evaluated by thrombelastography (TEG), in trauma patients is independently associated with increased 30-day mortality | Nystrup et al. Scandinavian Journal of Trauma Resuscitation and Emergency Medicine 2011 19 52 http content 19 1 52 SCANDINAVIAN JOURNAL OF trauma resuscitation a emergency medicine ORIGINAL RESEARCH Open Access Reduced clot strength upon admission evaluated by thrombelastography TEG in trauma patients is independently associated with increased 30-day mortality Kristin B Nystrup1 2 Nis A Windelov1 Annemarie B Thomsen2 and Par I Johansson1 Abstract Introduction Exsanguination due to uncontrolled bleeding is the leading cause of potentially preventable deaths among trauma patients. About one third of trauma patients present with coagulopathy on admission which is associated with increased mortality and will aggravate bleeding in a traumatized patient. Thrombelastographic TEG clot strength has previously been shown to predict outcome in critically ill patients. The aim of the present study was to investigate this relation in the trauma setting. Methods A retrospective study of trauma patients with an injury severity qualifying them for inclusion in the European Trauma Audit and Research Network TARN and a TEG analysis performed upon arrival at the trauma centre. Results Eighty-nine patients were included. The mean Injury Severity Score ISS was 21 with a 30-day mortality of 17 . Patients with a reduced clot strength maximal amplitude 50 mm evaluated by TEG presented with a higher ISS 27 95 CI 20-34 vs. 19 95 CI 17-22 p than the rest of the cohort. Clot strength correlated with the amount of packed red blood cells p fresh frozen plasma p and platelet concentrates p transfused during the first 24 hours of admission. Patients with low clot strength demonstrated increased 30day mortality 47 vs. 10 p . By logistic regression analysis reduced clot strength was an independent predictor of increased mortality after adjusting for age and ISS. Conclusion Low clot strength upon admission is independently associated with increased 30-day .

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