Disseminated Intravascular Coagulation (DIC) at an Early Phase of Trauma Continuously Proceeds to DIC at a Late Phase of Trauma

• Published in: Clinical and applied thrombosis/hemostasis Vol. 18; no. 4; pp. 364 - 369
• Main Authors: Murakami, Hiromoto, Gando, Satoshi, Hayakawa, Mineji, Sawamura, Atsushi, Sugano, Masahiro, Kubota, Nobuhiko, Uegaki, Shinji, Jesmin, Subrina
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.07.2012; SAGE PUBLICATIONS, INC
• Subjects: Adult; Aged; Disseminated Intravascular Coagulation - epidemiology; Disseminated Intravascular Coagulation - etiology; Disseminated Intravascular Coagulation - pathology; Disseminated Intravascular Coagulation - physiopathology; Female; Humans; Incidence; Male; Middle Aged; Retrospective Studies; Sepsis; Sepsis - epidemiology; Sepsis - etiology; Sepsis - pathology; Sepsis - physiopathology; Trauma Severity Indices; Wounds and Injuries - complications; Wounds and Injuries - epidemiology; Wounds and Injuries - pathology; Wounds and Injuries - physiopathology; trauma; fibrinolysis; coagulopathy; disseminated intravascular coagulation (DIC); sepsis; organ dysfunction
• ISSN: 1076-0296; 1938-2723
• DOI: 10.1177/1076029611426138

The data from 254 patients with severe trauma were retrospectively analyzed. The patients were subdivided into disseminated intravascular coagulation (DIC) and non-DIC. There was a difference in the incidence of the continuous progression from the early to late phase of DIC between the patients with and without DIC on day 0. While 2 of 9 patients who newly developed late-phase DIC were complicated with sepsis, none of the 32 patients who showed a continuous progression of DIC from the early to late phase of trauma developed sepsis. The DIC and Sequential Organ Failure Assessment scores on day 0 were independent factors that predicted the continuous progression of the DIC from the early to late phase of trauma. Trauma itself, but not sepsis, contributes to the continuous progression of DIC from the early to late phase of trauma. The severity of DIC and organ dysfunction are involved in the pathogenesis of this continuous progression.