Acute traumatic coagulopathy
Related Experiment Video
Updated: Sep 25, 2026

Determination of the Procoagulant Activity of Extracellular Vesicle (EV) Using EV-Activated Clotting Time (EV-ACT)
Published on: August 4, 2023
Karim Brohi1, Jasmin Singh, Mischa Heron
1Trauma and Critical Care Unit, Royal London Hospital, United Kingdom. karim@trauma.org
Background:
Traumatic coagulopathy is thought to be caused primarily by fluid administration and hypothermia.
Methods:
A retrospective study was performed to determine whether coagulopathy resulting from the injury itself is a clinically important entity in severely injured patients.
Results:
One thousand eight hundred sixty-seven consecutive trauma patients were reviewed, of whom 1,088 had full data sets. Median Injury Severity Score was 20, and 57.7% had an Injury Severity Score > 15; 24.4% of patients had a significant coagulopathy. Patients with an acute coagulopathy had significantly higher mortality (46.0% vs. 10.9%; chi2, p < 0.001). The incidence of coagulopathy increased with severity of injury, but was not related to the volume of intravenous fluid administered (r2 = 0.25, p < 0.001).
Conclusion:
There is a common and clinically important acute traumatic coagulopathy that is not related to fluid administration. This is a marker of injury severity and is related to mortality. A coagulation screen is an important early test in severely injured patients.
Related Concept Videos
Coagulation
During the coagulation phase, clotting factors, or procoagulants, play a vital role in initiating and progressing the coagulation cascade. This cascade is a series of reactions...
Coagulation
Introduction to Hemostasis
The three phases of hemostasis involve many clotting factors present in plasma and several substances released by platelets and injured tissue cells. It is a fast, localized, and...
Extrinsic and Intrinsic Pathways of Hemostasis
The Extrinsic Pathway
The extrinsic pathway of coagulation is typically initiated by tissue damage that exposes blood to tissue factor (TF), a protein released by the damaged tissue cells outside the blood vessels—this interaction with TF triggers biochemical reactions involving specific clotting factors. The key player here is Factor VII, which forms a...
Hemorrhagic Stroke ll: Pathophysiology
Anticoagulant Drugs: Low-Molecular-Weight Heparins
