Analysis of factors associated with coagulation dysfunction in patients with multiple trauma and moderate/severe brain injury

YU Peng-tao; LIU Kui; SONG Jie; HAO Ji-shan

doi:10.3969/j.issn.1009-4237.2017.04.008

Abstract：Objective To study the factors associated with coagulation dysfunction in patients with multiple trauma combined with moderate/severe brain injury.Methods Clinical data of 120 patients from Jan.2007 to Jan.2014 suffered multiple trauma combined with brain injury were retrospectively reviewed.Coagulation function tests were performed at 48 hours after admission.The patients were divided into two groups,68 cases in group A had coagulation dysfunction,and 52 cases in group B had not.The factors potentially associated with coagulation dysfunction as age,gender,smoking history,alcoholism,GCS,shock index,combined injuries,intracranial hemorrhage,fluid resuscitation were statistically analyzed.Results There was no significant difference in the characteristics of age,gender and smoking history between the two groups (P＞0.05).While shock (OR=3.073,P=0.036),severe brain injury(OR=1.794,P＜0.001),fluid resuscitation(OR=0.312,P=0.035),multiple cerebral contusion and laceration(OR=2.911,P=0.040),combined thoracic and/or abdominal injury(OR=3.008,P=0.041),alcoholism(OR=2.664,P=0.047),were significantly related to coagulation dysfunction.After 6 months of follow-up,the Glasgow outcome scale of the patients in group B was better than that in group A by Ridit Analysis(RiditA=0.613,RiditB=0.464,t=2.107,P=0.046).Conclusion The coagulation function is one of the important factors which affect prognosis of patients with multiple trauma combined with moderate/severe brain injury.The patients combined with shock,thoracic and/or abdominal injury,multiple cerebral contusion and laceration are apt to develop coagulation dysfunction.Limited fluid resuscitation can reduce the probability of coagulation dysfunction,and further improve the outcome.