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Updated: Oct 3, 2025
Measurement of Factor V Activity in Human Plasma Using a Microplate Coagulation Assay
Published on: September 9, 2012
Assessing Factor V Antigen and Degradation Products in Burn and Trauma Patients
John W Keyloun1, Tuan D Le2, Thomas Orfeo3
1The Burn Center, Department of Surgery, MedStar Washington Hospital Center, Washington, District of Columbia; Firefighters' Burn and Surgical Research Laboratory, MedStar Health Research Institute, Washington, District of Columbia.
Introduction:
Proposed mechanisms of acute traumatic coagulopathy (ATC) include decreased clotting potential due to factor consumption and proteolytic inactivation of factor V (FV) and activated factor V (FVa) by activated protein C (aPC). The role of FV/FVa depletion or inactivation in burn-induced coagulopathy is not well characterized. This study evaluates FV dynamics following burn and nonburn trauma.
Methods:
Burn and trauma patients were prospectively enrolled. Western blotting was performed on admission plasma to quantitate levels of FV antigen and to assess for aPC or other proteolytically derived FV/FVa degradation products. Statistical analysis was performed with Spearman's, Chi-square, Mann-Whitney U test, and logistic regression.
Results:
Burn (n = 60) and trauma (n = 136) cohorts showed similar degrees of FV consumption with median FV levels of 76% versus 73% (P = 0.65) of normal, respectively. Percent total body surface area (TBSA) was not correlated with FV, nor were significant differences in median FV levels observed between low and high TBSA groups. The injury severity score (ISS) in trauma patients was inversely correlated with FV (ρ = -0.26; P = 0.01) and ISS ≥ 25 was associated with a lower FV antigen level (64% versus. 93%; P = 0.009). The proportion of samples showing proteolysis-derived FV was greater in trauma than burn patients (42% versus. 16%; P = 0.0006).
Conclusions:
Increasing traumatic injury severity is associated with decreased FV antigen levels, and a greater proportion of trauma patient samples exhibit proteolytically degraded FV fragments. These associations are not present in burns, suggesting that mechanisms underlying FV depletion in burn and nonburn trauma are not identical.
Insights
Injury severity impacts factor V (FV) levels and degradation differently in trauma versus burn patients. Trauma patients with higher injury severity scores show reduced FV antigen and more FV degradation, unlike burn patients, indicating distinct coagulopathy mechanisms.
Area of Science:
- Coagulation science
- Trauma research
- Burn medicine
Background:
- Acute traumatic coagulopathy (ATC) involves decreased clotting potential, potentially from factor consumption and proteolytic inactivation of factor V (FV) and activated factor V (FVa) by activated protein C (aPC).
- The specific role of FV/FVa depletion or inactivation in burn-induced coagulopathy remains unclear.
- This study investigates FV dynamics in patients experiencing burn and nonburn trauma.
Purpose of the Study:
- To evaluate factor V (FV) dynamics following burn and nonburn trauma.
- To compare FV consumption and degradation patterns between burn and trauma patients.
- To explore the relationship between injury severity and FV levels/degradation.
Main Methods:
- Prospective enrollment of burn (n=60) and trauma (n=136) patients.
- Quantification of FV antigen and assessment of proteolytically derived FV degradation products using Western blotting on admission plasma.
- Statistical analysis including Spearman's, Chi-square, Mann-Whitney U test, and logistic regression.
Main Results:
- Both burn and trauma cohorts exhibited similar FV consumption (median FV levels 76% vs. 73%).
- Injury Severity Score (ISS) in trauma patients inversely correlated with FV levels (ρ = -0.26; P = 0.01), with ISS ≥ 25 associated with lower FV antigen (64% vs. 93%).
- A higher proportion of trauma patients (42%) showed proteolysis-derived FV compared to burn patients (16%).
Conclusions:
- Increasing traumatic injury severity is linked to decreased FV antigen levels and increased FV degradation in trauma patients.
- These associations were not observed in burn patients, suggesting divergent mechanisms of FV depletion.
- The findings indicate that the underlying mechanisms of FV depletion differ between burn and nonburn trauma.
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