Abstract text (incl. references and figure legends)
Introduction
The aim of the study is to identify related factors in mortality and blood transfusion in trauma patients using thromboelastography.
Material and Methods
It is a retrospective and observational study. The patients who visited the trauma center Uijeongbu Saint Mary's Hospital of the Catholic Medical University of Korea from March. 2018 to December. 2018 were enrolled. The exclusion criteria were <19 years old, with severe burn injury, in pregnancy, and taking antiplatelets or anticoagulants. Totally 452 patients were included. We evaluated the thromboelastography(TEG) parameters and classic coagulation tests. The requirement of transfusion and mortality were also investigated.
Results
The mean age was 52.3 years and the mortality rate was 39/452 (8.6%). The independent factors associated with mortality were lower GCS, longer TEG K-time, and lower TEG MA. The lower MA group demonstrated the highest probability of survival (odds ratio 0.207), followed by prolonged R-time (odds ratio 0.220). The patient numbers in fibrinolysis shutdown (SD), physiologic fibrinolysis, and hyperfibrinolysis groups were 219 (52.3%), 131 (31.4%), and 68 (16.3%), respectively. The mortality rates of fibrinolysis SD group (11.9%) and hyperfibrinolysis (8.8%) were higher than the physiologic fibrinolysis groups (3.8%). The cutoff obtained from ROC analysis was found to be suitable for predicting survival. The transfusion requirements were significantly higher in the fibrinolysis SD group than in the other two groups
Conclusion
Compared to the classic coagulation tests, TEG-based parameters were more useful for making a diagnosis in coagulopathies and predicting the survival of the patients. Compared to the physiologic fibrinolysis group, the dysfunctional fibrinolysis group showed higher mortality. Using TEG parameters and integrating them, prompt diagnosis and treatment of coagulopathies would be possible. It would lead to a decrease in trauma patients' preventable deaths.
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