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Risk Factors of Cosgriff et al for Severe Coagulopathy in a Trauma Patient Who Has Been Massively Transfused

Description

Cosgriff et al identified risk factors associated with the development of severe coagulopathy in a trauma patient who has received massive blood transfusion. These can help to identify a patient who may benefit from more aggressive management. The authors are from the Denver Health Medical Center.


 

Patient selection: trauma patient who has received > 10 units of packed RBCs in 24 hours.

 

Parameters:

(1) arterial pH

(2) body temperature

(3) Injury Severity Score (ISS)

(4) systolic blood pressure

 

Parameter

Findings

Points

arterial pH

>= 7.10

0

 

< 7.10

1

body temperature

>= 34°C

0

 

< 34°C

1

ISS

<= 25

0

 

> 25

1

systolic blood pressure

>= 70 mm Hg

0

 

< 70 mm Hg

 

 

total number of risk factors =

= SUM(points for all 4 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 4

• The higher the score the greater the risk for a severe coagulopathy. When 2 risk factors were present the risk was 39 to 49%. When all 4 were present the risk was 98%.

 


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