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- Title
Disseminated intravascular coagulation immediately after trauma predicts a poor prognosis in severely injured patients.
- Authors
Wada, Takeshi; Shiraishi, Atsushi; Gando, Satoshi; Yamakawa, Kazuma; Fujishima, Seitaro; Saitoh, Daizoh; Kushimoto, Shigeki; Ogura, Hiroshi; Abe, Toshikazu; Mayumi, Toshihiko; Sasaki, Junichi; Kotani, Joji; Takeyama, Naoshi; Tsuruta, Ryosuke; Takuma, Kiyotsugu; Yamashita, Norio; Shiraishi, Shin-ichiro; Ikeda, Hiroto; Shiino, Yasukazu; Tarui, Takehiko
- Abstract
Trauma patients die from massive bleeding due to disseminated intravascular coagulation (DIC) with a fibrinolytic phenotype in the early phase, which transforms to DIC with a thrombotic phenotype in the late phase of trauma, contributing to the development of multiple organ dysfunction syndrome (MODS) and a consequently poor outcome. This is a sub-analysis of a multicenter prospective descriptive cross-sectional study on DIC to evaluate the effect of a DIC diagnosis on the survival probability and predictive performance of DIC scores for massive transfusion, MODS, and hospital death in severely injured trauma patients. A DIC diagnosis on admission was associated with a lower survival probability (Log Rank P < 0.001), higher frequency of massive transfusion and MODS and a higher mortality rate than no such diagnosis. The DIC scores at 0 and 3 h significantly predicted massive transfusion, MODS, and hospital death. Markers of thrombin and plasmin generation and fibrinolysis inhibition also showed a good predictive ability for these three items. In conclusion, a DIC diagnosis on admission was associated with a low survival probability. DIC scores obtained immediately after trauma predicted a poor prognosis of severely injured trauma patients.
- Subjects
HEMORRHAGE; DISSEMINATED intravascular coagulation; THROMBOSIS; MULTIPLE organ failure; WOUNDS &; injuries
- Publication
Scientific Reports, 2021, Vol 11, Issue 1, p1
- ISSN
2045-2322
- Publication type
Article
- DOI
10.1038/s41598-021-90492-0