Prothrombin time predicting time‐dependent and risk‐stratified mortality
in polytrauma patients
Dublin Core
Title
Prothrombin time predicting time‐dependent and risk‐stratified mortality
in polytrauma patients
in polytrauma patients
Subject
Watson trauma pathway explorer, Trauma, Coagulopathy
Description
Abstract
Background Polytrauma is associated with a high mortality rate and often accompanied by coagulopathy. Pro‐
thrombin time (PT) is a prognostic factor for mortality in polytrauma patients.
The aim was to analyze the time- and severity-dependent role of PT in polytrauma patients related to mortality.
Methods Patients (≥16 years) with an Injury Severity Score≥16 were retrospectively included, yielding 2890 cases
after exclusion criteria. PT was measured at admission and 1, 2, 3, 4, 6, 8, 12, 24, and 48 h thereafter, reported as per‐
centage activity of the reference reagence [%].
According to survival status, two groups were formed and compared. Binary logistic regression was used to test PT
as an independent predictor for mortality. A closest top-left threshold method served for calculating threshold values
between the survivor and non-survivor group. Patients were divided into subgroups according to PT levels and mor‐
tality was assessed for each subgroup at each time point.
Results PT values in the non-survivor group were lower throughout the measuring period (p<0.05). PT threshold
values declined from admission until 2 h afterwards, reaching less than 50%. Already a slightly compromised PT
(≤70%) represented a significant factor (p<0.05) for mortality at early and late time points, associated with a rate
of more than 20%. In extremis, PT values of≤25% were related to a mortality rate of more than 50% up to four hours
after admission.
Conclusion There are early and significant differences in mortality according to PT values in polytrauma patients
(despite resuscitation measures), urging for a fast correction of PT. Time-dependent and stratified referencing may
help clinicians estimate the mortality risk and decide upon the extent of surgical care.
Keywords Watson trauma pathway explorer, Trauma, Coagulopathy
Background Polytrauma is associated with a high mortality rate and often accompanied by coagulopathy. Pro‐
thrombin time (PT) is a prognostic factor for mortality in polytrauma patients.
The aim was to analyze the time- and severity-dependent role of PT in polytrauma patients related to mortality.
Methods Patients (≥16 years) with an Injury Severity Score≥16 were retrospectively included, yielding 2890 cases
after exclusion criteria. PT was measured at admission and 1, 2, 3, 4, 6, 8, 12, 24, and 48 h thereafter, reported as per‐
centage activity of the reference reagence [%].
According to survival status, two groups were formed and compared. Binary logistic regression was used to test PT
as an independent predictor for mortality. A closest top-left threshold method served for calculating threshold values
between the survivor and non-survivor group. Patients were divided into subgroups according to PT levels and mor‐
tality was assessed for each subgroup at each time point.
Results PT values in the non-survivor group were lower throughout the measuring period (p<0.05). PT threshold
values declined from admission until 2 h afterwards, reaching less than 50%. Already a slightly compromised PT
(≤70%) represented a significant factor (p<0.05) for mortality at early and late time points, associated with a rate
of more than 20%. In extremis, PT values of≤25% were related to a mortality rate of more than 50% up to four hours
after admission.
Conclusion There are early and significant differences in mortality according to PT values in polytrauma patients
(despite resuscitation measures), urging for a fast correction of PT. Time-dependent and stratified referencing may
help clinicians estimate the mortality risk and decide upon the extent of surgical care.
Keywords Watson trauma pathway explorer, Trauma, Coagulopathy
Creator
Philipp Vetter1* , Cédric Niggli1 , Jan Hambrecht1 , Daniel Haschtmann2 , Hans‐Christoph Pape1 and
Ladislav Mica1
Ladislav Mica1
Source
https://doi.org/10.1186/s12245-025-00841-3
Date
2025
Contributor
Peri Irawan
Format
pdf
Language
english
Type
text
Files
Collection
Citation
Philipp Vetter1* , Cédric Niggli1 , Jan Hambrecht1 , Daniel Haschtmann2 , Hans‐Christoph Pape1 and
Ladislav Mica1, “Prothrombin time predicting time‐dependent and risk‐stratified mortality
in polytrauma patients,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12686.
in polytrauma patients,” Repository Horizon University Indonesia, accessed April 11, 2026, https://repository.horizon.ac.id/items/show/12686.