Combining Early Coagulation and Inflammatory Status Improves Prediction of Mortality in Burned and Nonburned Trauma Patients

Predicting survival in thermal injury: A systematic review of methodology of composite prediction models

“…Three studies produced a curve on which a composite score could be plotted to give a mortality risk [2,67,70]. Five studies produced a multivariable model but did not provide conversion to a risk of mortality [4,68,82,98,99]. Twenty-seven studies produced models with limited reproducibility by employing variables prone to inter-observer variability e.g.…”

Monitoring the coagulation status of trauma patients with viscoelastic devices

“…It was also reported that abnormalities of R and MA values measured by TEG® were independent predictive factors for poor outcome [33][34][35][36]. It has been demonstrated that prolongation of CFT and a decrease in MCF which indicate a decrease in platelet count measured by ROTEM® were correlated more strongly with poor outcome than with mortality calculated with the Trauma and Injury Severity Score (TRISS) equation [32,37]. It has been reported that a decrease in fibrinogen level which is detectable in the early stage of coagulopathy was also correlated with poor outcome, suggesting the use of fibrinogen level as the standard for administration of cryoprecipitate and fibrinogen preparations [30].…”

“…If the α angle was normal but MA which represents the strength of the blood clot was reduced, the patient was considered to have platelet dysfunction or a coagulopathy, and platelet concentrate or recombinant factor VII was administered. Several studies conducted in other countries reported the use of viscoelastic devices in trauma care and demonstrated their usefulness for the assessment of traumatic coagulopathy [32,35,[41][42][43][44].…”

“…Then, a very firm thrombus is formed by activated platelets and coagulation factors. Therefore, the AR-chip enables us to assess the cooperative capacity of platelets and the coagulation system in thrombus formation 48 [32]. It was also reported that abnormalities of R and MA values measured by TEG® were independent predictive factors for poor outcome [33][34][35][36].…”

Individualizing Optimal Fluid Resuscitation in Patients with Major Burns: Emerging Role for Hydrocortisone, Proteinuria and Brain Natriuretic Peptide

“…These differences may be explained in part by differences in each individual genetic make-up [17,18]. Burn trauma also induces coagulopathy and combining a patient's early coagulation and inflammatory status in addition to standard clinical indices improves prognostic models [19]. Since capillary leakage is probably invoked by cytokines measuring those cytokine profiles and/or genetic testing also might be of use in determining in which patients interventions aimed at reducing capillary leakage may be beneficial.…”