COAGULOPATHY–PREDICTIBILITY OR NON- PREDICTIBILITY IN THE ABDOMINAL TRAUMA?

Authors: Oana BULAT, Cristian BULAT, Bogdan DIACONU, Ioana LUPUSORU, Sorin UNGURIANU, Bogdan CIUNTU, Viorel SCRIPCARIU

Abstract:

Early post-traumatic, the risk of bleeding is very high not only for the lesions of the parenchymal organs or of the big vessels, but also of the acute coagulopathy, more often than not, these two factors combining themselves and thus complicating also the diagnosis and treatment, and negatively influencing the prognosis. The coagulopathy can appear immediately after the trauma, being quoted in about 25-35 % of the patients. Being in a close connection with the severity of the lesions, and thus with the ISS, the coagulopathy represents an independent risk factor for death, the later one increasing exponentially. The authors have carried out a retrospective observational study, between January 2015 and July 2017, on patients admitted in the 3rd and 4th Surgery clinics with the diagnosis of blunt abdominal traumatism (abdominal contusion). The patients included were with various mechanisms, only with parenchymal organs and with coagulation tests studied at 24, 48 and 72 hours from admission. The coagulation test was not with statistically significance (Pearson test) for the hospital stay, the same as for the trauma scores. Although literature provides several elements within the coagulation with role as factors with predictive value for survival and for the hospital admission duration in the traumatised patient, within our study, the parameters of the coagulation has influenced to a smaller degree the hospital admission duration and almost not at all the survival, this being due to a large degree to the nonhomogeneous lot of patients with various lesions of the parenchymal organs.

Keywords:
  • blunt abdominal trauma
  • coagulopathy
  • predictive factors.