1. Influence of surgical bleeding on the relationship between admission coagulopathy and risk of massive transfusion: lesson from 704 severe trauma patients
- Author
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Pauline Deras, A. Dehon, Pascal Latry, Jean-François Schved, E. Boissier, Jonathan Charbit, Karim Lakhal, Xavier Capdevila, Hôpital Lapeyronie [Montpellier] (CHU), Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier), Département d'hématologie biologique[Montpellier], Université Montpellier 1 (UM1)-Centre Hospitalier Régional Universitaire [Montpellier] (CHRU Montpellier)-CHU Saint-Eloi, Institut des Neurosciences de Montpellier - Déficits sensoriels et moteurs (INM), and Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Montpellier (UM)
- Subjects
Adult ,Male ,Risk ,medicine.medical_specialty ,Adolescent ,education ,Acute trauma coagulopathy ,Blood Loss, Surgical ,030204 cardiovascular system & hematology ,Logistic regression ,standard coagulation tests ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Odds Ratio ,Coagulopathy ,Humans ,Medicine ,Blood Transfusion ,Retrospective Studies ,Prothrombin time ,Receiver operating characteristic ,medicine.diagnostic_test ,business.industry ,[SDV.MHEP.HEM]Life Sciences [q-bio]/Human health and pathology/Hematology ,030208 emergency & critical care medicine ,Retrospective cohort study ,prediction ,Hematology ,General Medicine ,Blood Coagulation Disorders ,Middle Aged ,medicine.disease ,prothrombin time ,Surgery ,ROC Curve ,Severe trauma ,Area Under Curve ,trauma management ,haemorrhagic shock ,Wounds and Injuries ,Population study ,Female ,Partial Thromboplastin Time ,business ,Packed red blood cells - Abstract
Background This study hypothesized that the relationship between early coagulopathy and massive transfusion (MT) in trauma was highly dependent on the presence of surgical bleeding. Methods Consecutive severe trauma patients admitted to our institution over a 4-year period were included in this retrospective study. Surgical bleeding was defined as an injury requiring an invasive endovascular or surgical haemostatic procedure. The ability of prothrombin time ratio (PTr) and activated partial thromboplastin time ratio (aPTTr) to predict MT (≥10 units of packed red blood cells during the first 24 h) was determined by ROC curves. The strength of association and interaction between PTr, surgical bleeding and MT was assessed using a logistic regression analysis. Results Among the 704 patients included (ISS 21·0 ± 16·2), MT rate was higher in patients with surgical bleeding than in those with no surgical bleeding (47% vs. 5%; P
- Published
- 2016
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