Analysis of blood coagulation abnormality signs among patients with severe combined craniofacial trauma

Abstract

Objective. The aim of this paper is to study the pattern of blood coagulation abnormality signs among patients with severe combined craniofacial trauma and their relationship with the trauma outcomes. Materials and methods. A comparative analysis was carried out of the signs of trauma-induced coagulopathy (platelet count, international normalized ratio and activated partial thromboplastin time) on the 1st and 3rd days of hospital stay in two groups of patients with severe combined craniofacial trauma. The first group included 21 patients with a favorable outcome, the second — 37 patients with an unfavorable outcome. Also, a comparative analysis was carried out of the unfavorable outcome frequency among patients, depending on the trauma-induced coagulopathy presence on the 1st and 3rd days of hospital stay. Results. The analysis revealed the presence of statistically significant differences in the mean values of activated partial thromboplastin time on the 1st and 3rd days of hospital stay and of international normalized ratio on the 3rd day of hospital stay among patients with favorable and unfavorable outcomes (p<0.05). Differences in the platelets count on the 1st and 3rd days of hospital stay were not statistically significant (p>0.05). The proportion of patients with signs of trauma-induced coagulopathy on the 1st day was 63.8% (37 patients). On the 3rd day, their proportion increased up to 84.5% (49 patients). The frequency difference of the unfavorable outcomes among patients with signs of trauma-induced coagulopathy and those with blood coagulation signs within the physiological norm on the 1st and 3rd days of hospital stay was not statistically significant. Conclusion. Trauma-induced coagulopathy often occurs in patients with severe combined craniofacial trauma in its acute period, which must be taken into account when performing surgical interventions and intensive care for the patients. According to the study results, it is not possible to confirm the significant impact of this pathology on the outcomes of severe combined craniofacial trauma.