Acute burn induced coagulopathy

Parker, Michael, Sherren, Peter B., Hussey, Joseph, Martin, Rebecca V., Kundishora, Tapiwa and Emerson, Bruce (2013) Acute burn induced coagulopathy. Burns: Journal of the International Society for Burn Injuries, 39 (6). pp. 1157-1161. ISSN 1879-1409

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Background: Acute traumatic coagulopathy is well described in the trauma population. Major burns are characterised by a similar endothelial injury and cellular hypoperfusion. These features could be a driver for an acute burn induced coagulopathy (ABIC). Methods: Patients admitted to a regional burn centre over a 71 months period with a total body surface area burn of 30% or more were identified. The metavision electronic patient database was scrutinised for a predetermined list of demographics, interventions and admission investigations to identify any clinically significant ABIC. Results: On admission 39.3% of the 117 patients analysed met our criteria for a coagulopathy. Of the patients with a coagulopathy, 71.7% had an elevated Prothrombin Time (PT), 2.2% had an elevated Activated Partial Thromboplastin time (APPT) and 26.1% had an elevation of both. Patients with a coagulopathy received a similar volume of fluid (p = 0.08). There was a statistically significant correlation between the PT and the abbreviated burn severity index (p = 0.0013, r = 0.292) and serum lactate (p = 0.0013, r = 0.292). ABIC was an independent predictor of 28 day mortality, OR 3.42(1.11–10.56). Conclusion: In patients with major thermal injuries a clinically significant ABIC exists. Early diagnosis and treatment of ABIC should be considered particularly in those undergoing total burn wound excision.

Item Type: Journal Article
Keywords: Coagulopathy, Burn, Abbreviated burn severity index (ABSI), Prothrombin time (PT), Activated partial thromboplastin time (APTT)
Faculty: ARCHIVED Faculty of Health, Social Care & Education (until September 2018)
Depositing User: Repository Admin
Date Deposited: 29 Nov 2013 13:20
Last Modified: 09 Sep 2021 16:16

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