Prognostic value of the lethal triad among patients with multiple trauma

Background: Patients who have suffered multiple traumatic injuries, have a serious risk for death. Hypothermia, acidosis and coagulopathy are three complications in these patients, whose presence is known as lethal triad and indicates bad prognosis. Aim: To determine if the lethal triad in multiple trauma patients is associated with higher mortality and Injury Score Severity (ISS). Material and Methods: One hundred multiple trauma patients aged 26 to 56 years (90 males), admitted to an emergency room, were studied. Body temperature, prothrombin time, partial thromboplastin time, platelet count and blood gases were determined on admission. Results: Twenty six patients had the lethal triad and 15% died in the emergency room within the first 6 hours. No death was recorded among the 74 patients without the lethal triad. The mean ISS among patients with and without the lethal triad was 31.7 and 25.6, respectively (p<0.05). Conclusions: The presence of the lethal triad among patients with multiple trauma is associated with a higher mortality and ISS.