Acute renal injury (ARI) and blood transfusion requirements There were more ARI in the coagulopathic group 25 (25.3%) patients than in the non coagulopathic group 7 (8.4%) (p=0.003). This is comparable with other studies done outside Uganda on ATC [6,7]. However the exact relationship between ARI and ATC needs to be further investigated. There was no strong association between blood transfusion requirements

and coagulopathy. A total of 41(41.4%) of patients with coagulopathy were transfused and 27 (32.5%) of patients without coagulopathy were transfused with different blood products (p=0.179). Increased transfusion requirements in major trauma patients were probably due to two events; blood loss at the scene (event) and continue Inhibitors,research,lifescience,medical loss secondary to coagulopathy. Lack of significant difference in our study could be because of non compliance to standard

protocol as far as blood transfusions practices is concerned in our setting Inhibitors,research,lifescience,medical because in part there is frequently inadequate supply of blood during the day but more so at night. Mortality The overall mortality was 38(20.9%), this is higher mortality than what has been reported in developed world. Kirya reported a mortality of 39(26%) among major trauma patients in a study of outcome of major trauma patients at Mulago hospital 10 years ago [24]. Other studies reported an overall mortality among major trauma patients ranging from 15% to 20%, however Inhibitors,research,lifescience,medical these studies where done in high resourced trauma centres [6,10,11]. The mortality was more in the coagulopathic group 29(29.3%) than in the non coagulopathic group 9(12.2%) P=0.002, this is comparable with other studies [6,10,11]. Inhibitors,research,lifescience,medical In this study, coagulopathy was a strong predictor of mortality in major trauma patients (IRR 2.7 95% CI 1.3 – 5.7, p = 0.001) and a predictor of morbidity (longer length of

stay). The Kaplan-Meier survival curves suggest Inhibitors,research,lifescience,medical a significant difference in AZD9291 ic50 probability of survival between patients with elevated PTT and those with normal (p=0.001). Most deaths resulting from elevated PTT occur early in the hospital stay, with the probability of survival paralleling between the two groups as time goes on. Thus PTT was a strong predictor of outcome than PT. Multiple regressions showed PTT, systolic BP, GCS were the variables that influenced outcome the most. The ability to determine whether the trauma patient at admission all is coagulopathic or not is a single most important predictor of outcome. This is comparable with other studies on ATC [6,7,10]. This study was not without limitations; perhaps additional variables such as INR (International Normalized Ratio), temperature (to detect hypothermia), metabolic acidosis and fibrin break down products would have added valuable information to ascertain coagulopathy. So is the lack of blood products that is encountered often times in the late night hours we did not catergorise which patient came at night or during the day.