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Prothrombin time predicting time-dependent and risk-stratified mortality in polytrauma patients
Philipp Vetter1, Cédric Niggli2, Jan Hambrecht2
1Department of Trauma Surgery, University Hospital Zurich, Zurich, 8091, Switzerland. p.vetter.med@gmail.com.
International Journal of Emergency Medicine
|April 2, 2025
Summary
Prothrombin time (PT) is a key indicator of mortality in polytrauma patients. Lower PT levels significantly correlate with increased mortality risk, emphasizing the need for rapid PT correction.
Area of Science:
- Trauma care
- Coagulation disorders
- Prognostic markers
Background:
- Polytrauma presents a high mortality risk, often complicated by coagulopathy.
- Prothrombin time (PT) serves as a critical prognostic factor for mortality in polytrauma cases.
Purpose of the Study:
- To investigate the time- and severity-dependent relationship between Prothrombin time (PT) and mortality in polytrauma patients.
- To analyze PT as an independent predictor of mortality in this patient cohort.
Main Methods:
- Retrospective analysis of 2890 polytrauma patients (Injury Severity Score ≥ 16).
- Prothrombin time (PT) measured at multiple time points post-admission (0-48 hours).
- Statistical analysis including binary logistic regression and threshold calculation to assess PT's predictive value for mortality.
Main Results:
- Non-survivors exhibited consistently lower Prothrombin time (PT) values compared to survivors (p < 0.05).
- PT levels below 70% significantly predicted mortality (p < 0.05) with >20% mortality rate.
- PT values ≤ 25% within 4 hours were associated with >50% mortality.
Conclusions:
- Early and significant differences in mortality are evident based on Prothrombin time (PT) values in polytrauma patients, even with resuscitation.
- Prompt correction of PT is crucial for improving outcomes in polytrauma.
- Time-dependent and stratified PT referencing can aid clinicians in estimating mortality risk and guiding surgical decisions.
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