The ‘triad of death’ consists of the presence of acidosis, coagulopathy and hypothermia in an injured patient. It is very difficult to reverse and is consequently associated with a high fatality, making it a dreaded presentation which requires high vigilance and swift action. This article aimed to look closer at these presentations, their outcomes and management.

It was found that the mortality rates for this presentation are still high, despite a general decrease in patient fatality following major trauma. All three components appear to increase the likelihood of death individually. However, when all three occur together, one can additionally worsen the effect of the others causing what is referred to as a “vicious cycle resulting in death”. Nevertheless, the presence of severe coagulopathy is linked with higher risk than the extremes of the other two in a “triad of death” presentation. New agents targeting this are therefore suggested.

Full article:
PMID: 21785151

Title: Trauma patients with the ‘triad of death’
Authors: Mitra B, Tullio F, Cameron PA, Fitzgerald M
Journal: Emergency Medicine Journal