[Massive hemorrhage and mechanisms of coagulopathy in trauma]

Investigation of Frequency of the Lethal Triad and Its 24 Hours Prognostic Value among Patients with Multiple Traumas

BACKGROUND:

Death in multiple trauma (MT) patients is one of the serious concerns of the medical service provider. Any prediction of the likelihood of death on the assessment of the patient’s condition is performed using different variables, one of the tools in the triage of patients to determine their condition.

AIM:

We aimed to investigate the frequency and the predictive value of death in 24 hours triad of death in patients qualified with multiple traumas admitted to Imam Khomeini hospital.

METHODS:

This was a prospective cross-sectional study to determine the prevalence and predictive value of 24-hour triad of death among patients with MT referred to an emergency department. Three factors including acidosis, hypothermia and coagulopathy and predictive value of 24-hour death were evaluated. Arterial blood gas, oral temperature and blood samples for coagulation factors were analysed. Data were analysed using SPSS version 19. Multivariate analysis (logistic regression) was used to determine the predictive value of the triad of death.

RESULTS:

A group of 199 MT patients referring to Imam Khomeini hospital during the first 6 months of 2015 were evaluated for the first 24 hours of admission. Logistic regression analysis showed that using the following formula based on the triad of death can predict death in 96% of cases can be based on the triad of a death foretold death upon admission to the emergency room. It should be noted that this prediction tool as 173 people left alive after 24 hours as live predicts (100% correct).

CONCLUSION:

The triad of death is one of the tools in the triage of patients to determine their condition and care plan to be used, provided valuable information to predict the prognosis of patients with a medical team.