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Table 2 Demography, injury severity, transfusion requirements, mortality, biochemistry and hemostasis, thrombelastography and biomarkers of coagulopathy in 80 trauma patients stratified according to TEG profile (normal, hypercoagulability, hypocoagulability, hyperfibrinolysis)

From: Thrombelastography and biomarker profiles in acute coagulopathy of trauma: a prospective study

   Normal Hyper- coagulable Hypo- coagulable Hyper- fibrinolysis p-valuea
   (51-69 mm) (> 69 mm) (< 51 mm) (< 51 mm/> 8%)  
Demography, injury severity, transfusion and mortality
N   69 9 1 1  
Age yrs 44 (32-58) 72 (59-80) 63 80 0.006
Gender m% (n) 68% (47) 56% (5) 100% 100% NS
Blunt trauma % (n) 90% (62) 100% 100% 100% NS
ISS score 18 (10-29) 17 (16-20) 25 50 NS
sTBI % (n) 30% (18) 33% (3) 100% 0% NS
GCS (PH) score 13 (6-15) 12 (9-14) 7 6 NS
Crystalloids (PH) ml 300 (0-1000) 500 (200-500) 0 500 NS
RBC 0-24 h units 0 (0-4) 0 (0-1) 0 45 NS
FFP 0-24 h units 0 (0-3) 0 (0-0) 0 36 NS
PLT 0-24 h units 0 (0-1) 0 (0-0) 0 15 NS
MT (> 10 RBC in 24 h) % (n) 14% (10) 0% 0% 100% 0.159
Mortality % (n) 16% (11) 22% (2) 0% 100% NS
Shock, sympathoadrenal activation, cell damage, biochemistry and hemostasis
SBP (PH) mmHg 135 (122-149) 129 (100-153) 170 95 NS
pH   7.34 (7.29-7.38) 7.37 (7.31-7.41) 7.38 7.06 NS
Lactate mmol/l 1.9 (1.4-2.9) 2.3 (1.4-2.8) 1.3 8.4 NS
SBE mmol/l -2.1 (-4.1--0.2) 0.3 (-2.0-0.7) -1.9 -10.7 0.127
Adrenaline pg/ml 295 (112-976) 1,163 (191-1,471) 298 5,427 0.169
Noradrenaline pg/ml 638 (276-1,307) 1,146 (120-2,540) 731 549 NS
HcDNA % 4.7 (0.1-13.5) 10.0 (7.2-16.4) 9.8 17.1 0.126
Hemoblobin mmol/l 8.4 (7.6-9.1) 7.5 (6.5-8.8) 8.8 6.4 NS
Platelet count 109/l 206 (173-251) 275 (185-306) 117 172 0.045
Fibrinogen g/l 2.3 (2.0-2.7) 3.1 (3.0-3.4) 1.1 1.1 < 0.001
FXIII microg/ml 29 (24-36) 37 (29-43) 21 18 0.096
vWF % 200 (127-225) 190 (151-222) 124 203 NS
APTT > 35 sec % (n) 7% (5) 0% 0% 100% NS
INR > 1.2 % (n) 13% (9) 0% 0% 100% 0.134
Thrombelastography
R min 5.6 (4.9-6.4) 5.4 (5.1-5.7) 6.7 6.1 NS
Angle degrees 65 (62-69) 70 (67-73) 41 54 0.027
MA mm 63 (61-66) 71 (69-73) 49 33 NA
Ly30 % 0.2 (0.0-0.6) 0.0 (0.0-0.0) 0 78 0.076
Platelet activation and thrombin generation
sCD40L pg/ml 292 (223-417) 332 (263-406) 399 1,431 NS
PF1.2 nmol/l 6.6 (2.7-18.0) 4.5 (1.0-22.4) 1.0 0.4 NS
TAT ng/ml 37 (31-43) 36 (31-44) 29 38 NS
Natural anticoagulation       
AT 103 U/l 0.92 (0.82-1.02) 0.95 (0.88-0.98) 0.98 0.61 NS
PC % 108 (91-124) 108 (100-135) 138 71 NS
APC ng/ml 9.8 (7.6-12.1) 9.3 (9.1-11.1) 13.7 10.3 NS
TFPI ng/ml 58 (44-78) 78 (57-84) 126 68 0.075
Fibrinolysis
D-dimer ng/ml 166 (122-173) 170 (141-174) 179 173 NS
tPA ng/ml 6.9 (3.6-12.0) 12.1 (5.8-14.8) 2.6 25.4 0.123
PAI-1 ng/ml 22 (12-38) 33 (24-68) 8 24 NS
PAP ng/ml 283 (45-619) 510 (331-1154) 0 316 0.126
  1. Data are presented as medians (IQR) or n (%), with p-values shown for variables with p < 0.200, and in bold for p < 0.050.
  2. aOnly patients with normal or hypercoagulable TEG MA were compared (Wilcoxon Rank Sum tests or Chi-square/Fischer exact tests, as appropriate) but data are presented on the two patients that displayed hypocoagulability (MA < 51 mm) and hypocoagulable hyperfibrinolysis (MA < 51 mm and Ly30 > 8%).
  3. ISS, injury severity score; sTBI, severe Traumatic Brain Injury, Abbreviated Injury Score head > 3; PH, pre-hospital at the site of injury; GCS, Glascow Coma Score scale; RBC, red blood cells; FFP, fresh frozen plasma; PLT, platelet concentrates; MT, > 10 RBC the initial 24 hours; SBP, systolic blood pressure; APTT, activated partial thromboplastin time; INR, international normalized ratio. Biomarker abbreviations, see Materials and Methods section, ELISA.