Coagulation studies in patients with orthopedic trauma

Area of Science:

• Orthopedic Surgery
• Trauma Care
• Hematology

Background:

• Traumatic coagulopathy is complicated by various factors including head injury, acidosis, hypothermia, massive transfusion, and hypoxia.
• Initial assessment of coagulopathy in trauma patients relies on tests like prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen level, platelet count, and D-dimer levels.

Purpose of the Study:

• To investigate the coagulation profile in patients experiencing orthopedic trauma.

Main Methods:

• A prospective study design was employed.
• Patients with severe complicating factors (head injury, acidosis, massive transfusion, hypoxia) were excluded.
• Coagulation parameters were assessed at admission, intraoperatively, and postoperatively.

Main Results:

• Of 48 patients, 80% had normal disseminated intravascular coagulation (DIC) scores on admission, and 20% had mild scores.
• Fibrinogen levels showed a significant progressive increase from pre-operation to post-operation (mean levels 518 ± 31, 582 ± 35, and 643 ± 27, respectively; P ≤ 0.02).
• Other coagulation parameters remained unchanged, and Injury Severity Scores did not correlate with DIC scores.

Conclusions:

• Orthopedic trauma patients, excluding those with severe complicating factors, exhibit a significant increase in fibrinogen levels.
• Standard coagulation parameters and DIC scores may not fully capture the hemostatic changes in these patients.
• Larger prospective studies are necessary to establish correlations between elevated fibrinogen levels and specific trauma or surgical characteristics.