EVALUATION OF ANTITHROMBIN- III IN MULTIPLE TRAUMATIC PATIENTS WITH TRAUMA SCORES IN THE EMERGENCY DEPARTMENT

Correspondence:
Cahfer GÜLOGLU, MD
Dicle Universitesi, Tip Fakültesi 
Department Of Emergency Medicine. 
21280, Diyarbakir, Turkey. 
Tel: +90 412.248-8155.
Fax: +90 412. 248-8440. 
Email: cahgul@hotmail.com

Key words: Anti-thrombin-III, Multiple trauma, Trauma score

Abstract
Purpose: In this prospective study, we aimed to show how trauma severity and posttraumatic time effect some blood parameters such as anti-thrombin III (AT-III), blood thrombocyte count, active partial thromboplastine time (aPTT), prothrombin time (PT), and fibrinogen level. 

Methods: Thirty patients with multiple trauma admitted to Dicle University Hospital, department of emergency between January 1998-March 1999 were evaluated. Bloods were taken intravenously from all patients at admission and third posttraumatic days for evaluating parameters. Patients were divided into 3 groups according to injury severity score (ISS) and Glasgow Coma Score (GCS): 

Group 1- patients (n=8) with severe multiple trauma and severe head trauma (ISS>25, GCS<8); Group 2- patients (n=8) with severe trauma and mild head trauma (ISS >25, GCS>12); Group 3- patients (n=14) with mild multiple trauma and mild head trauma (ISS <25, GCS>12). Statistical analysis was done with SPSS 6.0 software. 

Results: Anti-thrombin III level was lower in-group 2 (high ISS) when compared to group 1 and 3 (p=0.007). Although AT-III level in group 2 was little but increased at 3rd day, it was still lower than group 1 and 3. Anti-thrombin levels of groups at admission and 3rd days were as follows: 32.3±11.5 mg/dl and 35±27.9 in group 1; 26.7± 8.1 mg/dl, 30.8± 11.8 mg/dl in group 2; 39.7± 8.9 mg/dl, 39.3±14.6 mg/dl in-group 3. No statistical differences were found in APTT, thrombocyte counts of groups (p>0.05). Prothrombin time was decreased at 3rd day when all patients were examined (p=0.0006). Although fibrinogens were in the normal levels in all groups, in-group 2 it was higher at admission when compared to other groups (p=0.02), no different was at 3rd day (p>0.05). 

Conclusion: As a conclusion, AT-III level decrease with severity of trauma. This may increase the risk of thrombo-emboli phenomena in multiple trauma patients.