Correlation between factor (F)XIa, FIXa and tissue factor and trauma severity

Area of Science:

• Biochemistry
• Trauma Pathophysiology
• Hemostasis

Background:

• Trauma patients exhibit heightened procoagulant activity, potentially linked to tissue factor (TF).
• Previous studies identified active Factor IXa (FIXa) and Factor XIa (FXIa) in trauma patient plasma.
• This study investigates TF, FIXa, and FXIa in relation to injury severity and shock in trauma patients.

Purpose of the Study:

• To evaluate the impact of injury severity and shock on TF, FIXa, and FXIa levels in trauma patients.
• To quantify the frequency and concentration of these factors in relation to trauma severity.
• To report the prevalence of active FIXa and FXIa in trauma patient plasma.

Main Methods:

• Eighty trauma patients were stratified into four groups based on Injury Severity Score and base deficit.
• Plasma samples were collected at initial hospital arrival and stored.
• Assays for FXIa, FIXa, and TF activity were performed using thrombin generation response to inhibitory antibodies.

Main Results:

• Tissue factor (TF) frequency and concentration were significantly higher in severe injury groups compared to non-severe groups.
• Factor XIa (FXIa) concentrations were approximately fourfold higher in trauma patients experiencing shock.
• Active FIXa and FXIa were detected in the majority of trauma patient plasma samples, with no endogenous activity in healthy controls.

Conclusions:

• Higher trauma severity correlates with increased TF frequency and concentration.
• Shock is associated with elevated FXIa concentrations in trauma patients.
• The widespread presence of active FIXa and FXIa in trauma patients is reported for the first time.