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Acute traumatic coagulopathy among major trauma patients in an urban tertiary hospital in sub Saharan Africa

BACKGROUND: Mortality from trauma remains a major public health issue as it is the leading cause of death in persons aged 5 to 44 years .Uncontrolled hemorrhage and coagulopathy is responsible for over 50% of all trauma related deaths within the first 48hrs of admission. Coagulation profiles are not...

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Autores principales: Mujuni, Erick, Wangoda, Robert, Ongom, Peter, Galukande, Moses
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3528619/
https://www.ncbi.nlm.nih.gov/pubmed/23150904
http://dx.doi.org/10.1186/1471-227X-12-16
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author Mujuni, Erick
Wangoda, Robert
Ongom, Peter
Galukande, Moses
author_facet Mujuni, Erick
Wangoda, Robert
Ongom, Peter
Galukande, Moses
author_sort Mujuni, Erick
collection PubMed
description BACKGROUND: Mortality from trauma remains a major public health issue as it is the leading cause of death in persons aged 5 to 44 years .Uncontrolled hemorrhage and coagulopathy is responsible for over 50% of all trauma related deaths within the first 48hrs of admission. Coagulation profiles are not routinely done among trauma patients in resource limited settings and there is a paucity of data on acute traumatic coagulopathy (ATC) in sub Saharan Africa. The study was conducted to evaluate the prothrombin time and partial thromboplastin time (PT/PTT) as predictors of mortality and morbidity among major trauma patients. METHODS: A prospective cohort study was carried out, in which major trauma patients admitted in A&E department between December 2011 to April 2012 were recruited. Five (5) mls of venous blood was drawn from a convenient vein within 10 minutes of the patient’s arrival at A&E for analysis of PT/PTT. Patients were stratified into two groups by the presence/absence of coagulopathy then followed up for a 2 week period for morbidity and mortality. RESULTS: A total of 182 major trauma patients were recruited; 149 (81.9%) were males, the mean age was 29.5 years (SD 9.8). Prevalence of coagulopathy was 54% (98/182). The mean ISS for the ATC group was 36.9 and the non ATC group was 26.9 (p=0.001). Patients with ATC stayed longer in hospital 11.24 days than non ATC patients 8 days (p=0.001). ATC was strongly associated with ARI (p= 0.003). Mortality was more in the ATC group 29 deaths compared to 9 deaths in the non ATC group. PTT was a strong independent predictor of mortality. CONCLUSION: A significant proportion of major trauma patients were coagulopathic. Initial coagulation profile is useful in predicting outcomes for major trauma patients.
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spelling pubmed-35286192013-01-03 Acute traumatic coagulopathy among major trauma patients in an urban tertiary hospital in sub Saharan Africa Mujuni, Erick Wangoda, Robert Ongom, Peter Galukande, Moses BMC Emerg Med Research Article BACKGROUND: Mortality from trauma remains a major public health issue as it is the leading cause of death in persons aged 5 to 44 years .Uncontrolled hemorrhage and coagulopathy is responsible for over 50% of all trauma related deaths within the first 48hrs of admission. Coagulation profiles are not routinely done among trauma patients in resource limited settings and there is a paucity of data on acute traumatic coagulopathy (ATC) in sub Saharan Africa. The study was conducted to evaluate the prothrombin time and partial thromboplastin time (PT/PTT) as predictors of mortality and morbidity among major trauma patients. METHODS: A prospective cohort study was carried out, in which major trauma patients admitted in A&E department between December 2011 to April 2012 were recruited. Five (5) mls of venous blood was drawn from a convenient vein within 10 minutes of the patient’s arrival at A&E for analysis of PT/PTT. Patients were stratified into two groups by the presence/absence of coagulopathy then followed up for a 2 week period for morbidity and mortality. RESULTS: A total of 182 major trauma patients were recruited; 149 (81.9%) were males, the mean age was 29.5 years (SD 9.8). Prevalence of coagulopathy was 54% (98/182). The mean ISS for the ATC group was 36.9 and the non ATC group was 26.9 (p=0.001). Patients with ATC stayed longer in hospital 11.24 days than non ATC patients 8 days (p=0.001). ATC was strongly associated with ARI (p= 0.003). Mortality was more in the ATC group 29 deaths compared to 9 deaths in the non ATC group. PTT was a strong independent predictor of mortality. CONCLUSION: A significant proportion of major trauma patients were coagulopathic. Initial coagulation profile is useful in predicting outcomes for major trauma patients. BioMed Central 2012-11-14 /pmc/articles/PMC3528619/ /pubmed/23150904 http://dx.doi.org/10.1186/1471-227X-12-16 Text en Copyright ©2012 Mujuni et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Mujuni, Erick
Wangoda, Robert
Ongom, Peter
Galukande, Moses
Acute traumatic coagulopathy among major trauma patients in an urban tertiary hospital in sub Saharan Africa
title Acute traumatic coagulopathy among major trauma patients in an urban tertiary hospital in sub Saharan Africa
title_full Acute traumatic coagulopathy among major trauma patients in an urban tertiary hospital in sub Saharan Africa
title_fullStr Acute traumatic coagulopathy among major trauma patients in an urban tertiary hospital in sub Saharan Africa
title_full_unstemmed Acute traumatic coagulopathy among major trauma patients in an urban tertiary hospital in sub Saharan Africa
title_short Acute traumatic coagulopathy among major trauma patients in an urban tertiary hospital in sub Saharan Africa
title_sort acute traumatic coagulopathy among major trauma patients in an urban tertiary hospital in sub saharan africa
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3528619/
https://www.ncbi.nlm.nih.gov/pubmed/23150904
http://dx.doi.org/10.1186/1471-227X-12-16
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