Disseminated intravascular coagulation immediately after trauma predicts a poor prognosis in severely injured patients

Sci Rep. 2021 May 26;11(1):11031. doi: 10.1038/s41598-021-90492-0.

Abstract

Trauma patients die from massive bleeding due to disseminated intravascular coagulation (DIC) with a fibrinolytic phenotype in the early phase, which transforms to DIC with a thrombotic phenotype in the late phase of trauma, contributing to the development of multiple organ dysfunction syndrome (MODS) and a consequently poor outcome. This is a sub-analysis of a multicenter prospective descriptive cross-sectional study on DIC to evaluate the effect of a DIC diagnosis on the survival probability and predictive performance of DIC scores for massive transfusion, MODS, and hospital death in severely injured trauma patients. A DIC diagnosis on admission was associated with a lower survival probability (Log Rank P < 0.001), higher frequency of massive transfusion and MODS and a higher mortality rate than no such diagnosis. The DIC scores at 0 and 3 h significantly predicted massive transfusion, MODS, and hospital death. Markers of thrombin and plasmin generation and fibrinolysis inhibition also showed a good predictive ability for these three items. In conclusion, a DIC diagnosis on admission was associated with a low survival probability. DIC scores obtained immediately after trauma predicted a poor prognosis of severely injured trauma patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Coagulation
  • Cross-Sectional Studies
  • Disseminated Intravascular Coagulation*
  • Fibrinolysis
  • Humans
  • Male
  • Middle Aged
  • Prognosis