Full Text Available
Note: Clicking the button above will open the full text document at the original institutional repository in a new window.
The impact of thromboelastography on patients with penetrating abdominal trauma requiring intensive care
Background Trauma induced coagulopathy is a complex multifaceted process which contributes to higher mortality rates in severely injured trauma patients. Thromboelastography (TEG) is an effective test to detect TIC which assists in instituting goal directed therapy as part of damage control resuscit...
Saved in:
| Main Author: | |
|---|---|
| Other Authors: | |
| Format: | Thesis |
| Language: | English |
| Published: |
Division of General Surgery
2023
|
| Subjects: | |
| Tags: |
No Tags, Be the first to tag this record!
|
| _version_ | 1867614186139287552 |
|---|---|
| access_status_str | Open Access |
| author | Hannington, Matthew Ross |
| author2 | Navsaria, Pradeep H |
| author_browse | Hannington, Matthew Ross Navsaria, Pradeep H |
| author_facet | Navsaria, Pradeep H Hannington, Matthew Ross |
| author_sort | Hannington, Matthew Ross |
| collection | Thesis |
| description | Background Trauma induced coagulopathy is a complex multifaceted process which contributes to higher mortality rates in severely injured trauma patients. Thromboelastography (TEG) is an effective test to detect TIC which assists in instituting goal directed therapy as part of damage control resuscitation. Methods This retrospective study included all adult patients over a 36-month period with penetrating abdominal trauma who required a laparotomy, blood product transfusion and admission for critical care. Analysis included: demographics, admission data, 24-hour interventions, TEG parameters and 30-day outcomes. Results Eighty-four patients with a median age of 28 years were included. The majority (93%) suffered from a gunshot injury with 75% receiving a damage control laparotomy. Forty-eight patients (57%) had a TEG. Injury Severity Score and total fluid & blood product administered in the first 24 hours were all significantly higher in patients that had a TEG (p< 0.05). TEG profiles were: 42% normal, 42% hypocoagulable, 12% hypercoagulable and 4% mixed parameters. Fibrinolysis profiles were: 48% normal, 44% fibrinolysis shutdown and 8% hyperfibrinolysis. Mortality rate was 5% at 24 hours and 26% at 30 days, with no difference between the two groups. High grade complication rates, days on a ventilator and intensive care unit length of stay were all significantly higher in patients who did not have a TEG. Conclusion Trauma induced coagulopathy is common in severely injured penetrating trauma patients. The usage of a thromboelastogram did not impact on 24-hour or 30-day mortality but did result in a decreased intensive care stay and a decreased high grade complication rate. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/37310 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:48:02.277Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2023 |
| publishDateRange | 2023 |
| publishDateSort | 2023 |
| publisher | Division of General Surgery |
| publisherStr | Division of General Surgery |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/37310 The impact of thromboelastography on patients with penetrating abdominal trauma requiring intensive care Hannington, Matthew Ross Navsaria, Pradeep H Surgery Background Trauma induced coagulopathy is a complex multifaceted process which contributes to higher mortality rates in severely injured trauma patients. Thromboelastography (TEG) is an effective test to detect TIC which assists in instituting goal directed therapy as part of damage control resuscitation. Methods This retrospective study included all adult patients over a 36-month period with penetrating abdominal trauma who required a laparotomy, blood product transfusion and admission for critical care. Analysis included: demographics, admission data, 24-hour interventions, TEG parameters and 30-day outcomes. Results Eighty-four patients with a median age of 28 years were included. The majority (93%) suffered from a gunshot injury with 75% receiving a damage control laparotomy. Forty-eight patients (57%) had a TEG. Injury Severity Score and total fluid & blood product administered in the first 24 hours were all significantly higher in patients that had a TEG (p< 0.05). TEG profiles were: 42% normal, 42% hypocoagulable, 12% hypercoagulable and 4% mixed parameters. Fibrinolysis profiles were: 48% normal, 44% fibrinolysis shutdown and 8% hyperfibrinolysis. Mortality rate was 5% at 24 hours and 26% at 30 days, with no difference between the two groups. High grade complication rates, days on a ventilator and intensive care unit length of stay were all significantly higher in patients who did not have a TEG. Conclusion Trauma induced coagulopathy is common in severely injured penetrating trauma patients. The usage of a thromboelastogram did not impact on 24-hour or 30-day mortality but did result in a decreased intensive care stay and a decreased high grade complication rate. 2023-03-07T11:03:45Z 2023-03-07T11:03:45Z 2022 2023-02-20T12:54:39Z Master Thesis Masters MMed http://hdl.handle.net/11427/37310 eng application/pdf Division of General Surgery Faculty of Health Sciences |
| spellingShingle | Surgery Hannington, Matthew Ross The impact of thromboelastography on patients with penetrating abdominal trauma requiring intensive care |
| thesis_degree_str | Master's |
| title | The impact of thromboelastography on patients with penetrating abdominal trauma requiring intensive care |
| title_full | The impact of thromboelastography on patients with penetrating abdominal trauma requiring intensive care |
| title_fullStr | The impact of thromboelastography on patients with penetrating abdominal trauma requiring intensive care |
| title_full_unstemmed | The impact of thromboelastography on patients with penetrating abdominal trauma requiring intensive care |
| title_short | The impact of thromboelastography on patients with penetrating abdominal trauma requiring intensive care |
| title_sort | impact of thromboelastography on patients with penetrating abdominal trauma requiring intensive care |
| topic | Surgery |
| url | http://hdl.handle.net/11427/37310 |
| work_keys_str_mv | AT hanningtonmatthewross theimpactofthromboelastographyonpatientswithpenetratingabdominaltraumarequiringintensivecare AT hanningtonmatthewross impactofthromboelastographyonpatientswithpenetratingabdominaltraumarequiringintensivecare |