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| The relationship between international normalized ratio and outcomes after injure |
| ZHONG Wei-xi，ZHU Xiao-guang，YANG Kai-chao，HUANG Jian-yin，YANG Yan-ping，WU Wei，ZHAO Gang，FENG Qi-ming |
| Department of Emergency Medicine，Shanghai Jiao Tong University Affiliated Sixth People’s Hospital，Shanghai 200233，China |
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Abstract Objectives To investigate the association between acute traumatic coagulopathy（ATC）defined by international normalized ratio（INR）≥1.3 and the outcomes after injury，and to investigate whether INR≥1.3 is an efficient predictor of multiple organ failure（MOF）and mortality in trauma patients. Methods A retrospective study was performed over a 12-month period in Emergency Department（ED）of Shanghai Sixth People‘s Hospital in 2014. After admission，data about age，gender，height，weight，injury severity score（ISS），INR，systolic blood pressure，Glasgow Coma Scale（GCS）at admission，transfusion volume，nosocomial infection（NI），MOF and mortality were recorded for each patient. Patients were divided into coagulopathy group and non-coagulopathy group according to INR in order to compare the outcomes（NI，MOF，mortality）between two groups. Results In an enrolled cohort of 488 patients，ATC was common（12.7%）. After controlling for important confounders by Logistic regression，ATC was independently associated with more than four-fold（OR＝4.56，95%CI1.53~13.61，P＝0.007）and three- fold（OR＝3.16，95% CI: 1.28~7.78，P＝0.012）greater risk of MOF and mortality，respectively. Especially in those patients（ISS＞25），the incidence of MOF was significant higher（OR＝13.83，95%CI: 6.594~119.96，P＝0.017）. Conclusion Trauma patients with ATC defined by INR≥1.3 have significant higher incidence rate of MOF and mortality. The increase of risk of MOF is more significant in extremely severe trauma patients（ISS＞25）. These data demonstrate INR≥1.3 can be an important predictor of MOF and mortality post-injury.
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Received: 22 December 2015
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Corresponding Authors:
FENG Qi-ming，E-mail: fengqiming04@126.com
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