Relationship between initial fibrinogen level with coagulopathy and mortality in multiple trauma patients

Reno Rudiman; Lyana Sulistyanti; Nurhayat Usman

doi:10.18203/2349-2902.isj20170194

Authors

Reno Rudiman Department of Surgery, Division of Digestive Surgery, Hasan Sadikin Hospital/Faculty of Medicine, Padjadjaran University, Bandung, West Java, Indonesia
Lyana Sulistyanti Department of Surgery, Division of Digestive Surgery, Hasan Sadikin Hospital/Faculty of Medicine, Padjadjaran University, Bandung, West Java, Indonesia
Nurhayat Usman Department of Surgery, Division of Digestive Surgery, Hasan Sadikin Hospital/Faculty of Medicine, Padjadjaran University, Bandung, West Java, Indonesia

DOI:

https://doi.org/10.18203/2349-2902.isj20170194

Keywords:

Coagulopathy, Fibrinogen, ISS, Multiple trauma, Mortality

Abstract

Background: In trauma induced coagulopathy (TIC), low fibrinogen value is often found and plasma fibrinogen reached low value earlier than other parameters of coagulation factors. Initial fibrinogen value is strongly correlated to the injury severity score (ISS) and be an independent predictor of mortality. This study was expected to see the relationship between initial fibrinogen level with coagulopathy and mortality, so it can predict early coagulopathy and can prevent bleeding complications that lead to mortality.

Methods: The study was conducted prospectively. The entire examination obtained from patients with multiple trauma. Fibrinogen levels and coagulopathy were taken from the blood laboratory tests in conjunction with other routine examination when patients were admitted to the ER of Hasan Sadikin General Hospital. Outcome parameters were the incidence of coagulopathy and mortality. Statistical analyses were performed to look at the significance of relationships.

Results: Of the 25 patients with multiple trauma obtained a majority of 80% were male patients and with the highest incidence mechanism was head trauma as many as 16 people (64%). There were 8 patients (32%) experienced coagulopathy and mortality occurred in 7 patients (28%). Chi square analysis found a significant association between fibrinogen and coagulopathy (p = 0.043), while the association between initial fibrinogen with mortality was not significant (p = 0.341).

Conclusions: Initial fibrinogen level is significantly associated with coagulopathy but it cannot predict mortality in patients with multiple trauma. Further study is needed in order to assess the benefit of these results on the management of multiple trauma patients.

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