title: Early coagulation disorders after severe burn injury: impact on mortality.
abstract: OBJECTIVE
  To evaluate the time course of coagulation markers in the early postburn period and clarify the role of coagulation alterations in organ failure and in mortality prognosis.
  
  
  METHODS
  This prospective study was conducted in the burn ICU of a tertiary hospital.
  
  
  METHODS
  45 patients with severe thermal burn injury.
  
  
  RESULTS
  Clinical data and coagulation and fibrinolysis parameters were measured during the first postburn week. The ICU 28-day mortality rate was 33%. Significant differences in the time course of coagulation markers were observed between survivors and nonsurvivors. SOFA score distinguished between patients with overt and nonovert disseminated intravascular coagulation (DIC) during the overall investigation period. Presence of overt DIC was related to mortality (OR=0.1). Antithrombin, protein S, plasminogen activator inhibitor 1, and SOFA score on day 3, protein C on day 5, and thrombin/antithrombin complexes on day 7 revealed a good prognostic value for ICU mortality, according to the area under ROC curves.
  
  
  CONCLUSIONS
  Severe thermal injury is associated with the early activation of coagulation cascade, presence of DIC, organ failure, and increased mortality.
authors.affiliation: Burn ICU Papanikolaou General Hospital, Exochi, Thessaloniki, Greece. alavrenti@gmail.com
authors.forename: Athina
authors.initials: A
authors.lastname: Lavrentieva
authors.forename: Theodore
authors.initials: T
authors.lastname: Kontakiotis
authors.forename: Militsa
authors.initials: M
authors.lastname: Bitzani
authors.forename: Georgia
authors.initials: G
authors.lastname: Papaioannou-Gaki
authors.forename: Angeliki
authors.initials: A
authors.lastname: Parlapani
authors.forename: Olimpia
authors.initials: O
authors.lastname: Thomareis
authors.forename: Nicolaos
authors.initials: N
authors.lastname: Tsotsolis
authors.forename: Maria-Amalia
authors.initials: MA
authors.lastname: Giala
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001779:Blood Coagulation Factors / Q000378:metabolism*; D001780:Blood Coagulation Tests; D002056:Burns / Q000150:complications* / Q000175:diagnosis / Q000401:mortality*; D004211:Disseminated Intravascular Coagulation / Q000175:diagnosis* / Q000209:etiology; D042241:Early Diagnosis; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D015996:Survival Rate
chemical_list: D015415:Biomarkers; D001779:Blood Coagulation Factors