Acute traumatic coagulopathy

J Trauma. 2003 Jun;54(6):1127-30. doi: 10.1097/01.TA.0000069184.82147.06.


Background: Traumatic coagulopathy is thought to be caused primarily by fluid administration and hypothermia.

Methods: A retrospective study was performed to determine whether coagulopathy resulting from the injury itself is a clinically important entity in severely injured patients.

Results: One thousand eight hundred sixty-seven consecutive trauma patients were reviewed, of whom 1,088 had full data sets. Median Injury Severity Score was 20, and 57.7% had an Injury Severity Score > 15; 24.4% of patients had a significant coagulopathy. Patients with an acute coagulopathy had significantly higher mortality (46.0% vs. 10.9%; chi2, p < 0.001). The incidence of coagulopathy increased with severity of injury, but was not related to the volume of intravenous fluid administered (r2 = 0.25, p < 0.001).

Conclusion: There is a common and clinically important acute traumatic coagulopathy that is not related to fluid administration. This is a marker of injury severity and is related to mortality. A coagulation screen is an important early test in severely injured patients.

MeSH terms

  • Acute Disease
  • Blood Coagulation Disorders / epidemiology*
  • Comorbidity
  • Emergency Medical Services / statistics & numerical data
  • Female
  • Fluid Therapy / statistics & numerical data
  • Humans
  • Incidence
  • Injury Severity Score
  • London / epidemiology
  • Male
  • Multiple Trauma / classification
  • Multiple Trauma / epidemiology*
  • Retrospective Studies
  • Survival Rate
  • Wounds, Nonpenetrating / epidemiology