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A New Paradigm to Consider

Jana B. A. MacLeod, MD

Arch Surg. 2008;143(8):797-801.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

Injury, intentional and unintentional, is one of the main causes of death for adult Americans.¹ Further, from 1999 to 2003, injury was the main cause of premature mortality (measured as potential years of life lost), ahead of malignancy and heart disease, for Americans who died before their 65th birthday.² Injuries that cause massive hemorrhage are often associated with the highest mortality rates. More than 50% of patients who present with massive hemorrhage die, and for those who die within hours of the injury event, it is often the most common cause of death.³

Over the past 3 decades, as trauma systems and designated trauma centers developed and matured, there has been a continual drop in the injury mortality rate in America. In the state of Georgia, the age-adjusted all-injury mortality rate has dropped 29% in 20 years, from 1981 to 2000.⁴ Trauma centers have been . . . [Full Text of this Article]

MASSIVE HEMORRHAGE AND METABOLIC FAILURE

SECONDARY CAUSES OF TRAUMA-RELATED COAGULOPATHY

Dilution

Depletion

Disseminated Intravascular Coagulation

COAGULOPATHY AS AN INDEPENDENT PREDICTOR OF MORTALITY

TRAUMATIC COAGULOPATHY AND HEAD INJURY

NEW PARADIGM

CONCLUSIONS

AUTHOR INFORMATION

Author Affiliation: Department of Surgery, Emory University School of Medicine, Atlanta, Georgia.

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