PP 106. Jaam Dic Score Can Predict Patient Death and Massive Transfusion in Trauma

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S. Gando, A Oshiro, Y. Yanagida, N. Henzan, Takahashi, H. Makise

16:36 - 16:42h at Margrit Room

Categories: Emergency Surgery

Session: Poster II (P3) - Emergency / Thoracic Surgery

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Background
We tested hypothesis that disseminated intravascular coagulation (DIC) score on admission can beused to predict the prognosis of patients with coagulopathy of trauma.

Material and Methods
We conducted a retrospective study of 338 patients whose data were obtained immediately after admission to the emergency department. We collected serial data for the platelet counts, global markers of coagulation and fibrinolysis and antithrombin levels. DIC was diagnosed according to the Japanese Association for Acute Medicine (JAAM) DIC scoring system.

Result
he higher levels of FDP and D-dimer and greater FDP/D-dimer ratios in the DIC patients suggested DIC with the fibrinolytic phenotype. The DIC patients with the fibrinolytic phenotype exhibited persistently lower platelet counts and fibrinogen levels, increased prothrombin time ratios, higher FDP and D-dimer levels, and lower antithrombin levels compared with the non-DIC patients on arrival to the emergency department and during the early stage of trauma. The JAAM DIC score and fibrinogen levels obtained immediately after arrival to the emergency department was an independent predictor of massive transfusion and death due to trauma and correlated with the amount of blood transfused.

Conclusion
Patients who develop DIC with the fibrinolytic phenotype during the early stage of trauma exhibit consumption coagulopathy associated with increased fibrin(ogen)olysis and lower levels of antithrombin. The JAAM DIC score and fibrinogen levels can be used to predict the prognosis of  patients with coagulopathy of trauma.