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Fibrinolysis in multisystem trauma patients.
B L Enderson1, J P Chen, R Robinson
1Department of Surgery, University of Tennessee Medical Center, Knoxville 37920.
The Journal of Trauma
|September 1, 1991
Summary
Acute trauma patients often show hypercoagulability and reduced fibrinolysis, regardless of injury severity. Early D-dimer testing may aid in managing thrombosis risk in these patients.
Area of Science:
- Coagulation and Fibrinolysis Research
- Trauma Pathophysiology
Background:
- The fibrinolytic system plays a crucial role in preventing pathological thrombosis.
- Acute trauma can significantly disrupt coagulation and fibrinolysis balance, leading to bleeding or clotting disorders.
Purpose of the Study:
- To investigate changes in fibrin degradation, hypercoagulability, and fibrinolysis in adult trauma patients.
- To correlate these hemostatic changes with injury severity, injury types, complications, and clinical coagulation tests.
Main Methods:
- Measurement of D-dimer (fibrin degradation products) to assess hypercoagulability.
- Assessment of plasminogen activators and antithrombin III to evaluate fibrinolysis.
- Analysis of 42 adult trauma patients, correlating findings with clinical data.
Main Results:
- Most patients exhibited hypercoagulability and suppressed fibrinolysis, independent of injury severity.
- These hemostatic alterations were most pronounced in patients with nervous system injuries.
- Some patients with less severe injuries but hypercoagulability developed pathological thrombosis.
Conclusions:
- Hypercoagulability and impaired fibrinolysis are common in acute trauma patients.
- D-dimer latex agglutination offers a rapid, potentially valuable tool for assessing fibrinolysis and thrombosis risk in trauma care.