Original CommunicationDisseminated intravascular coagulation at an early phase of trauma is associated with consumption coagulopathy and excessive fibrinolysis both by plasmin and neutrophil elastase
Section snippets
Patient selection
With the approval of the Institutional Review Board and after written informed consent was obtained from either the patients or their next of kin, 57 severe trauma patients defined as having an Injury Severity Score (ISS) ≥9 (at 1 abbreviated injury scale ≥3) were enrolled in the present study. Trauma patients under 12 yeas of age or older than 90 years of age, those with cardiac arrest or who had been resuscitated from cardiac arrest, and individuals receiving anticoagulant therapy and having
Baseline patient characteristics
Table III indicates that although the ISS and APACHE II scores are identical between the 2 groups, DIC patients demonstrate a severe degree of SIRS and organ dysfunction (SOFA) and were transfused with more blood products. Increased lactate levels in DIC patients suggest tissue hypoperfusion in this group. The prevalence of sepsis during the study period was 7% (4/57) and was distributed identically between the groups.
Serial changes in the DIC scores, platelet counts, coagulation, and fibrinolysis variables
Significant differences were observed in the JAAM and ISTH overt DIC scores
Discussion
The members of the Educational Initiative on Critical Bleeding in Trauma (EICBT) announced the new disease entities of acute coagulopathy of trauma shock and coagulopathy of trauma.22 They did not, however, propose clear definitions or diagnostic criteria, and a rebuttal has been made to these concepts.23 The acute coagulopathy of trauma has not been defined by the EICBT, but the EICBT has reconfirmed the presence of trauma-related DIC.1, 24, 25 Although traumatic coagulopathy is
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Cited by (0)
Supported by Grants-in-Aid for Scientific Research from the Ministry of Education, Science, Sports, and Culture in Japan (Grants 2007-19390456 and 2009-21249086).