The Coagulopathy-Predicting Factors in Acute Trauma Patients Using the Generalized Estimation Equations Model

Zahra Montazeri; Soleiman Kheiri; Shahram Paydar; Morteza Sedehi

doi:10.18502/jbe.v8i4.13351

Zahra Montazeri Department of Epidemiology and Biostatistics, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran.
Soleiman Kheiri Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran.Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran.
Shahram Paydar Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
Morteza Sedehi Department of Epidemiology and Biostatistics, School of Health, Shahrekord University of Medical Sciences, Shahrekord, Iran.

DOI: https://doi.org/10.18502/jbe.v8i4.13351

Keywords: Coagulopathy; Trauma; Generalized estimation equations

Abstract

Introduction: Coagulation disorder is one of the major phenomena following the trauma which can deteriorate the condition of the patients. The aim of this study is to determine some factors predicting the incidence of coagulation disorder among acute trauma patients.

Methods: The generalized estimation equations were used to determine the predictors of blood coagulation disorders in a sample of 736 people over 16 years of age with acute trauma in Shahid Rajaei Hospital in Shiraz. The response variable was converted based on PT, PTT, INR, and fibrinogen level criteria as a two-state variable (with/without coagulation disorder). In the data analysis, the correlation of the coagulation disorder was considered in the first and second stages.

Results:The prevalence of coagulation disorders (mild, moderate and severe) was 19% in two stages and coagulation disorders (moderate and severe) was 7.5%. Motor vehicle accident was the most common cause of injury.The variables of blood sugar, diastolic blood pressure, pH, and sodium had a significant effect on coagulation disorders (mild, moderate, and severe). Moreover, blood phosphorus, age, and pupillary reflex had a significant effect on coagulation disorders (moderate and severe).

Conclusion: Predictors of coagulation disorders (mild-moderate-severe) include blood sugar, diastolic blood pressure, pH, and sodium. Moreover, blood phosphorus, age, and pupil reflex are predictors of moderate and severe coagulopathy. this model that taking into account the exchangeable correlation of first- and second-stage coagulopathy had a better fit than the model ignoring this correlation.