title: The impact of coagulopathy on traumatic splenic injuries.
abstract: BACKGROUND
  Patients with pre-injury coagulopathy have worse outcomes than those without coagulopathy. This article investigated the risk-adjusted effect of pre-injury coagulopathy on outcomes after splenic injuries.
  
  
  METHODS
  Review of the National Trauma Data Bank from 2007 to 2010 comparing mortality and complications between splenic injury patients with and without a pre-injury bleeding disorder.
  
  
  RESULTS
  Of 58,896 patients, 2% had a bleeding disorder. Coagulopathic patients had higher odds of mortality (odds ratio, 1.3), sepsis (odds ratio, 2.0), acute respiratory distress syndrome (odds ratio, 2.6), acute renal failure (odds ratio, 1.5), cardiac arrest (odds ratio, 1.5), and overall complications (odds ratio, 2.4). The higher odds of myocardial infarction did not achieve statistical significance (odds ratio, 1.6).
  
  
  CONCLUSIONS
  Pre-injury coagulopathy in patients with splenic injury has a negative impact on cardiac arrest, sepsis, acute respiratory distress syndrome, acute renal failure, and mortality. The higher likelihood of myocardial infarction did not reach statistical significance.
authors.affiliation: Department of Surgery, Howard University Hospital, Howard University College of Medicine, Suite 4B02, 2041 Georgia Avenue NW, Washington, DC 20060, USA. Electronic address: drnormasmalls@gmail.com.
authors.forename: Norma
authors.initials: N
authors.lastname: Smalls
authors.affiliation: Department of Surgery, Howard University Hospital, Howard University College of Medicine, Suite 4B02, 2041 Georgia Avenue NW, Washington, DC 20060, USA.
authors.forename: Augustine
authors.initials: A
authors.lastname: Obirieze
authors.affiliation: Department of Surgery, Howard University Hospital, Howard University College of Medicine, Suite 4B02, 2041 Georgia Avenue NW, Washington, DC 20060, USA.
authors.forename: Imudia
authors.initials: I
authors.lastname: Ehanire
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001778:Blood Coagulation Disorders / Q000150:complications* / Q000401:mortality; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013154:Spleen / Q000293:injuries*; D013156:Splenectomy; D014481:United States; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000401:mortality* / Q000628:therapy; D014950:Wounds, Penetrating / Q000150:complications* / Q000401:mortality* / Q000628:therapy; D055815:Young Adult
keywords: Coagulopathy; Comorbidity; Complications; Splenic injuries