Clinical presentation and blood gas analysis of multiple trauma patients for prediction of standard coagulation parameters at emergency department arrival

Objectives Trauma-induced coagulopathy (TIC) in multiple trauma patients is a potentially lethal complication. Whether quickly available laboratory parameters using point-of-care (POC) blood gas analysis (BGA) may serve as surrogate parameters for standard coagulation parameters is unknown. The pres...

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Bibliographic Details
Published in:Der Anaesthesist 2016-04, Vol.65 (4), p.274-280
Main Authors: Hilbert-Carius, P., Hofmann, G. O., Lefering, R., Stuttmann, R., Struck, M. F.
Format: Article
Language:English
Subjects:
Accidents
Adult
Aged
Anesthesiology
Anticoagulants - therapeutic use
Blood Coagulation
Blood Gas Analysis
Critical Care Medicine
Emergency Medical Services - methods
Emergency Medicine
Emergency Service, Hospital
Female
Hemoglobins - analysis
Humans
Injury Severity Score
Intensive
Lactic Acid - blood
Male
Medicine
Medicine & Public Health
Middle Aged
Multiple Trauma - blood
Originalien
Pain Medicine
Partial Thromboplastin Time
Point-of-Care Systems
Predictive Value of Tests
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Summary:Objectives Trauma-induced coagulopathy (TIC) in multiple trauma patients is a potentially lethal complication. Whether quickly available laboratory parameters using point-of-care (POC) blood gas analysis (BGA) may serve as surrogate parameters for standard coagulation parameters is unknown. The present study evaluated TraumaRegister DGU® of the German Trauma Society for correlations between POC BGA parameters and standard coagulation parameters. Methods In the setting of 197 trauma centres (172 in Germany), 86,442 patients were analysed between 2005 and 2012. Of these, 40,129 (72 % men) with a mean age 46 ± 21 years underwent further analysis presenting with direct admission from the scene of the accident to a trauma centre, injury severity score (ISS)  ≥ 9, complete data available for the calculation of revised injury severity classification prognosis, and blood samples with valid haemoglobin (Hb) measurements taken immediately after emergency department (ED) admission. Correlations between standard coagulation parameters and POC BGA parameters (Hb, base excess [BE], lactate) were tested using Pearson’s test with a two-tailed significance level of p   16, ISS > 25, ISS > 16 and shock at ED admission, and patients with massive transfusion was likewise carried out. Results Correlations were found between Hb and prothrombin time (r = 0.497; p 
ISSN:0003-2417
1432-055X
DOI:10.1007/s00101-016-0150-y