Abstract
Objectives: To determine the prevalence of abnormal coagulation studies and to identify variables associated with markedly elevated coagulation studies in children with blunt trauma. Methods: We reviewed the medical records of all patients < 15 years old hospitalized at a Level 1 trauma center for either blunt head or torso trauma over a 4-year period. Data from each patient's emergency department (ED) presentation were abstracted. ED coagulation studies were defined prior to data analysis as elevated if the international normalized ratio (INR) was ≥1.2 or partial thromboplastin time (PTT) was ≥33.0 seconds and markedly elevated if the INR was ≥1.5 or PTT was ≥40 seconds. Variables associated with markedly elevated coagulation studies in a univariate analysis (P < 0.05) were entered into a backward elimination logistic regression analysis to identify variables independently associated with markedly elevated coagulation studies. Results: A total of 1082 patients' records were reviewed, and the 830 (77 %) patients with coagulation studies obtained composed the study population. Elevated coagulation studies were detected in 232 (28%) patients, and 49 (6%) of these were found to be markedly elevated. In the multivariate analysis, a GCS ≤13 (odds ratio [OR] 8.7, 95% confidence interval [CI] 4.3,17.7), low systolic blood pressure (OR 4.0, 95% CI 1.6, 9.9), open/multiple bony fractures (OR 2.9, 95% CI 1.4, 6.2), and major tissue wounds (OR 2.8, 95% CI 1.4, 5.6) were independently associated with markedly elevated coagulation studies. Conclusion: Hospitalized pediatric blunt trauma patients frequently have minor elevations in ED coagulation studies. Marked elevations occur infrequently and are independently associated with a GCS ≤13, low systolic blood pressure, open/multiple bony fractures, and major tissue wounds.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 324-328 |
| Number of pages | 5 |
| Journal | Pediatric Emergency Care |
| Volume | 17 |
| Issue number | 5 |
| DOIs | |
| State | Published - 2001 |
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Keywords
- Blunt trauma
- Coagulation tests
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Nursing(all)
- Emergency Medicine
Cite this
Coagulation testing in pediatric blunt trauma patients. / Holmes Jr, James F; Goodwin, H. C.; Land, C.; Kuppermann, Nathan.
In: Pediatric Emergency Care, Vol. 17, No. 5, 2001, p. 324-328.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Coagulation testing in pediatric blunt trauma patients
AU - Holmes Jr, James F
AU - Goodwin, H. C.
AU - Land, C.
AU - Kuppermann, Nathan
PY - 2001
Y1 - 2001
N2 - Objectives: To determine the prevalence of abnormal coagulation studies and to identify variables associated with markedly elevated coagulation studies in children with blunt trauma. Methods: We reviewed the medical records of all patients < 15 years old hospitalized at a Level 1 trauma center for either blunt head or torso trauma over a 4-year period. Data from each patient's emergency department (ED) presentation were abstracted. ED coagulation studies were defined prior to data analysis as elevated if the international normalized ratio (INR) was ≥1.2 or partial thromboplastin time (PTT) was ≥33.0 seconds and markedly elevated if the INR was ≥1.5 or PTT was ≥40 seconds. Variables associated with markedly elevated coagulation studies in a univariate analysis (P < 0.05) were entered into a backward elimination logistic regression analysis to identify variables independently associated with markedly elevated coagulation studies. Results: A total of 1082 patients' records were reviewed, and the 830 (77 %) patients with coagulation studies obtained composed the study population. Elevated coagulation studies were detected in 232 (28%) patients, and 49 (6%) of these were found to be markedly elevated. In the multivariate analysis, a GCS ≤13 (odds ratio [OR] 8.7, 95% confidence interval [CI] 4.3,17.7), low systolic blood pressure (OR 4.0, 95% CI 1.6, 9.9), open/multiple bony fractures (OR 2.9, 95% CI 1.4, 6.2), and major tissue wounds (OR 2.8, 95% CI 1.4, 5.6) were independently associated with markedly elevated coagulation studies. Conclusion: Hospitalized pediatric blunt trauma patients frequently have minor elevations in ED coagulation studies. Marked elevations occur infrequently and are independently associated with a GCS ≤13, low systolic blood pressure, open/multiple bony fractures, and major tissue wounds.
AB - Objectives: To determine the prevalence of abnormal coagulation studies and to identify variables associated with markedly elevated coagulation studies in children with blunt trauma. Methods: We reviewed the medical records of all patients < 15 years old hospitalized at a Level 1 trauma center for either blunt head or torso trauma over a 4-year period. Data from each patient's emergency department (ED) presentation were abstracted. ED coagulation studies were defined prior to data analysis as elevated if the international normalized ratio (INR) was ≥1.2 or partial thromboplastin time (PTT) was ≥33.0 seconds and markedly elevated if the INR was ≥1.5 or PTT was ≥40 seconds. Variables associated with markedly elevated coagulation studies in a univariate analysis (P < 0.05) were entered into a backward elimination logistic regression analysis to identify variables independently associated with markedly elevated coagulation studies. Results: A total of 1082 patients' records were reviewed, and the 830 (77 %) patients with coagulation studies obtained composed the study population. Elevated coagulation studies were detected in 232 (28%) patients, and 49 (6%) of these were found to be markedly elevated. In the multivariate analysis, a GCS ≤13 (odds ratio [OR] 8.7, 95% confidence interval [CI] 4.3,17.7), low systolic blood pressure (OR 4.0, 95% CI 1.6, 9.9), open/multiple bony fractures (OR 2.9, 95% CI 1.4, 6.2), and major tissue wounds (OR 2.8, 95% CI 1.4, 5.6) were independently associated with markedly elevated coagulation studies. Conclusion: Hospitalized pediatric blunt trauma patients frequently have minor elevations in ED coagulation studies. Marked elevations occur infrequently and are independently associated with a GCS ≤13, low systolic blood pressure, open/multiple bony fractures, and major tissue wounds.
KW - Blunt trauma
KW - Coagulation tests
UR - http://www.scopus.com/inward/record.url?scp=0034761954&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0034761954&partnerID=8YFLogxK
U2 - 10.1097/00006565-200110000-00002
DO - 10.1097/00006565-200110000-00002
M3 - Article
C2 - 11673707
AN - SCOPUS:0034761954
VL - 17
SP - 324
EP - 328
JO - Pediatric Emergency Care
JF - Pediatric Emergency Care
SN - 0749-5161
IS - 5
ER -