Email updates

Keep up to date with the latest news and content from BMC Emergency Medicine and BioMed Central.

Open Access Research article

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

Erick Mujuni1, Robert Wangoda2, Peter Ongom2 and Moses Galukande1*

Author Affiliations

1 Surgery Department, College of Health Sciences, Makerere University, Mulago Hill Road, P. O. Box 7072, Kampala, Uganda

2 Surgery Department, Mulago National Referral Hospital, Mulago Hill, P. O. Box 7051, Kampala, Uganda

For all author emails, please log on.

BMC Emergency Medicine 2012, 12:16  doi:10.1186/1471-227X-12-16

Published: 14 November 2012

Abstract

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.

Keywords:
Acute traumatic coagulopathy; PT/PTT; Major trauma