Does the Mechanism Matter? Comparing Thrombelastography Between Blunt and Penetrating Pediatric Trauma Patients
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Read the article on jpedsurg.org ↗Article · Sep 2021 · 1 min read
In brief
In brief
Comparative study of 118 pediatric trauma patients demonstrates that coagulopathy patterns on thrombelastography are similar between blunt solid organ injuries and penetrating trauma, suggesting mechanism is less important than presence of shock. Patients in shock showed significantly decreased alpha-angles and maximum amplitude, indicating shock state drives coagulation abnormalities regardless of injury mechanism.
Written by the GCMD Library team from the article.
Background/Purpose
The utility of thrombelastography (TEG) in pediatric trauma remains unknown, and differences in coagulopathy between blunt and penetrating mechanisms are not established. We aimed to compare TEG patterns in pediatric trauma patients with blunt solid organ injuries (BSOI) and penetrating injuries to determine the role of mechanism in coagulopathy.
Methods
Highest-level pediatric trauma activations with BSOI or penetrating injuries and admission TEG at two pediatric trauma centers were included. TEG abnormalities were defined by each institution's normative values and compared separately by injury mechanism and evidence of shock (elevated SIPA) using Kruskal-Wallis or Fisher's exact tests.
Results
Of 118 patients included, 64 had BSOI and 54 had penetrating injuries. There were no significant differences in TEG abnormalities between the BSOI and penetrating injury groups. Patients with shock were more likely to have decreased alpha-angles (30.9% vs. 8.0%, p=0.01) and decreased maximum amplitude (MA) (44.1% vs. 8.0%, p