A prospective study to assess serum level of soluble thrombomodulin as early marker of acute traumatic coagulopathy in polytrauma patients

Authors

  • Ruby Kataria Department of Trauma Surgery, AIIMS, Rishikesh, Uttarakhand, India
  • M. Quamar Azam Department of Trauma Surgery, AIIMS, Rishikesh, Uttarakhand, India
  • Geeta Negi Department of Transfusion Medicine, AIIMS, Rishikesh, Uttarakhand, India
  • Ajay Kumar Department of Trauma Surgery, AIIMS, Rishikesh, Uttarakhand, India
  • Bhaskar Sarkar Department of Trauma Surgery, AIIMS, Rishikesh, Uttarakhand, India
  • Madhur Uniyal Department of Trauma Surgery, AIIMS, Rishikesh, Uttarakhand, India

DOI:

https://doi.org/10.18203/2349-2902.isj20214375

Keywords:

ATC, Serum TM, Polytrauma, Blood transfusion, Lactate

Abstract

Background: Coagulopathy following major trauma is conventionally attributed to activation of coagulation factors. We hypothesized that early coagulopathy is due to tissue hypoperfusion and investigated thrombomodulin (TM) as early marker of endothelial injury in poly trauma patient.

Methods: This was a prospective cohort study of major trauma patients admitted to a single trauma center. Blood was drawn within 10 minutes of arrival for analysis of TM. We assess its association with blood transfusion, length of hospital stays and mortality.

Results: A total of 90 patients were enrolled. An increasing lactate was associated with high soluble TM. High TM was significantly associated with increased mortality, blood transfusion requirements, hospital stay.

Conclusions: Acute traumatic coagulopathy (ATC) occurs only in the presence of tissue hypoperfusion which we have measured in form of lactate and coagulopathy measured using international normalized ratio (INR) as standard. Admission serum TM can be predictive of clinical outcomes following major trauma.

Author Biography

Ruby Kataria, Department of Trauma Surgery, AIIMS, Rishikesh, Uttarakhand, India

Trauma surgery  

Mch 

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Published

2021-10-28

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Original Research Articles