Injury Severity is a Key Contributor to Coagulation Dysregulation and Fibrinogen Consumption

Area of Science:

• Trauma and Emergency Medicine
• Hematology
• Biochemistry

Background:

• Traumatic injury is a major cause of death, with hemorrhage accounting for 40% of fatalities in individuals under 45.
• Severe injury and hypoperfusion significantly alter coagulation, hindering stable clot formation and increasing mortality.

Approach:

• Quantified changes in clot formation and mechanics post-trauma using rheological, turbidimetric, and thrombin generation assays.
• Compared coagulation kinetics and mechanics between trauma patients and healthy donors.
• Utilized ELISA to measure fibrinolytic markers: tissue plasminogen activator (tPA) and D-dimer.

Key Points:

• Trauma patients, particularly those with higher Injury Severity Scores (ISS), exhibited reduced clot stiffness, increased fibrinolysis, and diminished thrombin generation compared to healthy controls.
• Fibrinogen concentration, clot stiffness, D-dimer, and tPA levels directly correlated with increasing ISS.
• Machine learning algorithms identified crucial clinical factors influencing patient outcomes.

Conclusions:

• Viscoelastic and biochemical assays reveal significant predictors of mortality in trauma patients.
• Findings support improved patient treatment strategies and the identification of novel therapeutic targets.