Lethal Triad of Endo et al

Patient selection: age >= 18 years, acute trauma with ISS >= 16

Outcome: 28-day mortality

Conventional lethal triad:

(1) INR > 1.50

(2) pH < 7.2

(3) core body temperature < 35°C

Novel "lethal triad" - one or both of the "novel triad":

(1) fibrinolytic disorder with FDP > 90 microgram per mL (major criteria, method and reference range not given)

(2) both of the following (minor criteria):

(2a) acidosis with base excess < -3 mmol/L

(2b) hypothermia with core body temperature < 36°C

Performance:

• The sensitivity was 81% and specificity 67%.

• The negative predictive value is 95% while the positive predictive value is 29%.