摘要
BACKGROUND:Hemorrhage is the second leading cause of death in trauma patients preceded only by traumatic brain injury. But hemorrhagic shock is the most common cause of preventable death within 6 hours of admission. Traumatic coagulopathy is a hypocoagulable state that occurs in the most severely injured. International normalized ratio(INR) and its relationship with trauma mortality have not been studied specifi cally. This study aimed to establish a predictive value of INR for trauma-related mortality.METHODS:A total of 99 trauma patients aged 18–70 years were included in the study. Their INR was determined and patient progression was followed up till death/discharge. According to previous retrospective studies,the cutoff value for INR in our study was kept at 1.5.RESULTS:The total mortality rate of the patients was 16.16%(16/99). The mean INR was 1.45 with a SD of 1.35. INR was deranged in a total of 14 patients(14.14%). Of these patients,11 died(78.57%) and 3 survived. INR was deranged in 11(68.75%) of the 16 patients who died,but 5 deaths(31.25%) had normal INR values. The sensitivity of INR was 69%(95%CI 41%–88%) and the specificity 96%(95%CI 90%–99%). The diagnostic accuracy of INR was 92%(95%CI 85%–96%). Positive predictive value and negative predictive value were 79%(95%CI 49%–95%) and 94%(95%CI 87%–98%),respectively.CONCLUSION:Our results showed that INR is a good predictor of mortality in trauma patients.
BACKGROUND: Hemorrhage is the second leading cause of death in trauma patients preceded only by traumatic brain injury. But hemorrhagic shock is the most common cause of preventable death within 6 hours of admission. Traumatic coagulopathy is a hypocoagulable state that occurs in the most severely injured. International normalized ratio (INR) and its relationship with trauma mortality have not been studied specifically. This study aimed to establish a predictive value of INR for trauma-related mortality. METHODS: A total of 99 trauma patients aged 18-70 years were included in the study. Their I NR was determined and patient progression was followed up till death/discharge. According to previous retrospective studies, the cutoff value for INR in our study was kept at 1.5. RESULTS: The total mortality rate of the patients was 16.16% (16/99). The mean INR was 1.45 with a SD of 1.35. INR was deranged in a total of 14 patients (14.14%). Of these patients, 11 died (78.57%) and 3 survived. INR was deranged in 11 (68.75%) of the 16 patients who died, but 5 deaths (31.25%) had normal INR values. The sensitivity of INR was 69% (95%CI41%-88%) and the specificity 96% (95%CI90%-99%). The diagnostic accuracy of INR was 92% (95%CI85%-96%). Positive predictive value and negative predictive value were 79% (95%CI49%-95%) and 94% (95%CI87%-98%), respectively.CONCLUSION: Our results showed that INR is a good predictor of mortality in trauma patients.