Resumen
Introduction: Every year six million people die from a traumatic injury, 40% of these deaths are due to post-trauma hemorrhage, being the first preventable cause of death worldwide. The presence and persistence of bleeding leads to trauma-induced coagulopathy (TIC), which plays an important role in the morbidity and mortality of these patients. Early detection and appropriate treatment of TIC has the potential to reduce patient mortality in this population. Objective: Analyze thromboelastography data to determine coagulation profile and correlate to the use of blood products and mortality, Methodology: A retrospective study was carried out with the data of post-trauma patients who underwent thromboelastography at the General Accidents Hospital of the Guatemalan Institute of Social Security (Instituto Guatemalteco de Seguridad Social) from 2018 to 2020. Evaluation and review of the thromboelastograph (TEG®), coagulation profile by thromboelastography, mortality, admission to intensive care, surgical intervention, length of hospital stay, amount and type of blood products used as transfusion therapy variables were carried out. Results: 384 patients were classified as having a fibrinolytic, hypocoagulable, hypercoagulable, hemorrhagic or normal profile according to their TEG® results. Of the total number of participants, 70.6% presented some coagulation disorder, and 29.4% met normal criteria. The average mortality in the study was 32.8%, with the highest mortality reported in patients with a hypocoagulable profile, 49.4%, followed by hemorrhagic, 37%, hypercoagulable, 28.9%, normal, 27.4%, and finally fibrinolytic profile, 18.6%. In addition, the transfusion therapy used was analyzed, being the concentration of red blood cells the most common therapy with 61.1%, followed by fresh frozen plasma with 28.7% and platelets with 10.2%. Conclusion: Thromboelastography is useful for classifying the coagulation profile of the post-trauma patient and is a laboratory study that allows determining the blood products that a trauma patient requires in order to reduce their mortality rate.
Citas
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