Coagulation dysfunction of severe burn patients: A potential cause of death

• Published in: Burns 2023-05, Vol.49 (3), p.678-687
• Main Authors: Zhang, Tie-ning, Ba, Te, Li, Fang, Chen, Qiang, Chen, Zhi-peng, Zhou, Biao, Yan, Zeng-qiang, Li, Quan, Cao, Sheng-jun, Wang, Ling-feng
• Format: Article
• Language: English
• Subjects: Blood Coagulation Disorders - epidemiology; Blood Coagulation Disorders - etiology; Burn; Burns; Cause of Death; Coagulation dysfunction; Humans; Inhalation injury; Retrospective Studies; Sepsis; Sepsis - epidemiology; Sepsis - etiology; Thrombophilia
• ISSN: 0305-4179; 1879-1409
• DOI: 10.1016/j.burns.2022.05.003

Research on coagulation dysfunction following burns is controversial. This study aimed to describe the coagulation changes in severe burn patients by examining coagulation parameters. Patients with third-degree total body surface area (TBSA) burns of ≥30% were enrolled between 2017 and 2020. Platelet (PLT) count and coagulation indexes (including APTT, INR, FIB, DD, and AT Ⅲ) were measured at admission and once weekly for 8 weeks, and statistical analysis was performed. The patient medical profiles were reviewed to extract demographic and clinical data, including TBSA, third-degree TBSA, and inhalation injury. The total intravenous fluids and transfusions of crystalloids, fresh frozen plasma (FFP), and red blood cells (RBC) were calculated during the forty-eight-hour period. The number of sepsis cases was recorded. We enrolled 104 patients , and while the overall coagulation trend fluctuated, inflection points appeared around one week and demonstrated hypercoagulability. INR was significantly higher in the non-survival group than in the survivors' group from admission to three weeks after burn (all p