Article Sidebar
Views article details: 28
Specialty of coagulopathy in the first 24 hours in severely burned patients at Le Huu Trac National Burn Hospital in 2024
Main Article Content
Abstract
Objective: To describe several coagulation indices and evaluate their associations with clinical and laboratory features in severe burn patients during the first 24 hours of hospitalization.
Subjects and methods: A cross-sectional descriptive study was conducted on 104 patients with severe burns admitted to the hospital within the first 24 hours and treated at the Intensive Care Unit - National Burn Hospital Le Huu Trac from January 2024 to January 2025.
Results: 19.2% of patients had a platelet count PLT < 150 G/L; 29.8% had a prothrombin time PT > 14s; 24% had a prothrombin ratio PT% < 70%; 13.5% had a fibrinogen level < 2 g/L; 39.4% had an international normalized ratio INR > 1.2; and 29.1% had an activated partial thromboplastin time APTT > 42s. There was a correlation between total burn area, deep burn area, respiratory burn with PT, PT%, INR, fibrinogen concentration, and APTT (p < 0.05). Additionally, total burn surface area was positively correlated with platelet count (r = 0.249; p = 0.011). Blood lactate levels were associated with PLT, PT, PT%, INR, and fibrinogen concentration (p < 0.05). Blood albumin levels were correlated with PT, PT%, INR, and APTT (p < 0.05). The rate of patients experiencing complications leading to death or discharge against medical advice was 26.9%. The most common complications were multiple organ dysfunction syndrome (20.2%), septic shock (10.6%), and acute respiratory distress syndrome (8.7%). Coagulation abnormalities, including PT > 14s, PT% < 70%, INR > 1.2, fibrinogen < 2 g/L, and APTT > 42s, were associated with increased risk of death or discharge against medical advice.
Conclusion: The rate of early coagulopathy in severe burn patients is still high. Total burn surface area, deep burns, inhalation injury, and elevated blood lactate levels are associated with the onset of early coagulopathy. Coagulopathy significantly increases the risk of death or premature discharge.
Article Details
Keywords
severe burns, coagulopathy
References
2. Colohan S. M. (2010) Predicting prognosis in thermal burns with associated inhalational injury: a systematic review of prognostic factors in adult burn victims. Journal of Burn Care Research, 31 (4), 529-539.
3. Foncerrada G., Culnan D. M., Capek K. D.et al. (2018) Inhalation injury in the burned patient. Annals of plastic surgery, 80 (3), S98-S105.
4. Ngô Minh Đức, Chu Anh Tuấn, Nguyễn Gia Tiếnet al. (2021) Đặc điểm và một số yếu tố tiên lượng tử vong ở bệnh nhân bỏng: Dữ liệu tại Bệnh viện Bỏng Quốc gia trong 10 năm (từ 2010 đến 2019). Tạp chí Y học Thảm hoạ và Bỏng, (1), 7-22.
5. Geng K., Liu Y., Yang Y.et al. (2020) Incidence and prognostic value of acute coagulopathy after extensive severe burns. Journal of Burn Care Research, 41 (3), 544-549.
6. Qiu L., Chen C., Li S.-J. et al. (2017) Prognostic values of red blood cell distribution width, platelet count, and red cell distribution width-to-platelet ratio for severe burn injury. Scientific Reports, 7 (1), 13720.