Hypocalcaemia and traumatic coagulopathy: an observational analysis

• DOI: 10.1111/vox.12875
• Publication Date: 2019-12-17T08:24:35Z
• Authors: Mayank Vasudeva; Joseph K. Mathew; Mark C. Fitzgerald; Zoe Cheung; Biswadev Mitra
• Keywords: Hypocalcaemia

Background and Objectives Haemorrhage‐associated calcium loss may lead to disruption of platelet function, intrinsic extrinsic pathway‐mediated haemostasis cardiac contractility. Among shocked major trauma patients, we aimed investigate the association between admission hypocalcaemia adverse outcomes. Materials Methods Data were extracted from Alfred Trauma Registry Applications Knowledge Management Department for all adult patients presenting directly scene with a shock index ≥1 1 July 2014 30 June 2018. Patients pre‐hospital blood transfusion excluded. Ionized was defined as <1·11 mmol/l, acute traumatic coagulopathy initial INR >1·5. Multivariable logistic regression analysis used assess that adjusted Injury Severity Score, GCS, bicarbonate lactate. Results There 226 included in final 113 (50%) recording ionized on presentation prior any product transfusion. associated (adjusted OR 2·9; 95% CI: 1·01–8·3, P = 0·048). Admission also requirement first 24 h post‐admission 62·5% hypocalcaemic compared 37·5% normocalcaemic ( < 0·001). death at hospital discharge (25·6% among 15·0% 0·047)). Conclusion Hypocalcaemia common finding independently coagulopathy. The early, protocolized administration haemorrhagic warrants further assessment randomized controlled trials.