Efficacy and prognostic analysis of prothrombin complex concentrate in 349 patients with trauma-induced coagulopathy
10.3760/cma.j.issn.1671-0282.2025.01.011
- VernacularTitle:349例创伤性凝血病患者凝血酶原复合物疗效及预后分析
- Author:
Xianhui MA
1
;
Yangbo KANG
;
Qi YANG
;
Hongbo DING
;
Jiasheng SHEN
;
Yong'an XU
Author Information
1. 浙江大学医学院附属第二医院急诊医学科 全省严重烧创伤诊治与应急救援重点实验室、浙江省急危重症临床医学研究中心，杭州 310009
- Keywords:
Trauma-induced coagulopathy;
Prothrombin Complex Concentrate;
treatment effect
- From:
Chinese Journal of Emergency Medicine
2025;34(1):70-77
- CountryChina
- Language:Chinese
-
Abstract:
Objective:Efficacy of prothrombin complex concentration (PCC) and analysis of prognostic factors in patients with traumatic trauma-induced coagulopathy (TIC).Methods:A retrospective study was conducted on patients with TIC admitted to 11 hospitals from January to December 2021. The data included baseline characteristics, injury information, blood product transfusions (including PCC treatment), laboratory examination at admission and 24 hour-after admission, treatment measure, pre-hospitalization time, and clinical outcomes (improvement at discharge, length of hospital stay). The patients were divided into a conventional group and a PCC group according to whether they were treated with PCC. Propensity score matching method was used to match the patients at a 1:1 ratio, and the differences in different indicators between the groups were compared. Univariate and multivariate logistic regression analyses were performed to identify prognostic factors for TIC patients.Results:After propensity score matching, 103 patients were identified in both the PCC and conventional groups. Univariate logistic regression analysis revealed no significant differences in age, gender, Glasgow Coma Scale (GCS) score, injury severity score, acute physiology and chronic health evaluation score, underlying diseases, pre-hospitalization time, injury type and site, and treatment measure (use of vasoactive drugs, calcium agents, tranexamic acid, and emergency surgery) between the two groups (all P>0.05). Compared with the conventional group, the PCC group exhibited lower 24-hour white blood cell counts, lactate level, prothrombin time, and international normalized ratio (INR) (all P<0.05), whereas hemoglobin level and pH value were higher (both P<0.05). The PCC group also had a shorter hospital stay (13 d vs. 15 d, P<0.05). However, there was no significant difference in the rate of improvement at discharge between the two groups ( P=0.308). Multivariate logistic regression revealed that age (>68 years), GCS score (<5 points), fibrinogen (FIB) level (after 24 h, <2.04 g/L), and INR (after 24 h, >1.455) were independent risk factors affecting the prognosis of TIC patients, and the AUCs were 0.632, 0.702, 0.733, and 0.752, respectively. Conclusions:Treatment with PCC in TIC patients can correct coagulation dysfunction and reduce hospital stay. Age, GCS score, FIB level and INR after 24 h affect the clinical prognosis of TIC patients, which requires special attention.
