Abstract:
Background. Polytrauma is a significant cause of mortality among young and active
patients, frequently accompanied by severe hemostatic disorders. Massive hemorrhage
accounts for approximately 1.9 million deaths annually worldwide (WHO, 2023),
necessitating early and effective diagnosis and treatment.
Objective(s). Determining the frequency and characteristics of hemostatic disorders in
polytraumatized patients, along with assessing their impact on prognosis in the intensive
care unit.
Materials and methods. A retrospective study was conducted on a cohort of
polytraumatized patients admitted to the ICU, assessing coagulation parameters such as PT,
INR, APTT, fibrinogen, and D-dimers, alongside the need for blood products and mortality.
Descriptive statistics and chi-square tests were applied to identify significant associations
(p < 0.05).
Results. Eighty patients were enrolled in the study, with a mean age of 42.6 ± 15.3 years.
Hemostatic disorders were identified in 65% of cases, predominantly acute traumatic
coagulopathy and hypofibrinogenemia. Patients exhibiting severe coagulation
abnormalities showed a significant prolongation of activated partial thromboplastin time
(APTT), exceeding 50% above normal values. This impairment resulted in an increased need
for fresh frozen plasma transfusions, averaging 4.2 units per patient. The mortality rate in
this subgroup was 28%, significantly higher compared to 9% mortality in patients without
significant hemostatic dysfunctions (p = 0.03).
Conclusion(s). Hemostatic disorders are frequently observed in polytrauma cases and are
associated with poor prognosis. Study findings highlight the necessity of active coagulation
monitoring and early initiation of hemostatic treatment to effectively reduce mortality
among affected patients.
