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Acquired Factor XIII Deficiency in Critical Care: Registry-Based Analysis of Features, Symptoms and Risk Factors
Michael Hetz1, Michaela Wilhelmi2, Lutz Mirow3
1Department of Orthopedics, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany.
Summary
Acquired Factor XIII (FXIII) deficiency diagnosis and treatment are challenging. Real-world data suggest FXIII supplementation is often initiated below 60%-70% activity for bleeding and wound healing issues.
Area of Science:
- Hematology
- Clinical Medicine
- Pharmacology
Background:
- Factor XIII (FXIII) deficiency presents diagnostic and treatment challenges in clinical practice.
- It is associated with increased bleeding risk and delayed wound healing.
Purpose of the Study:
- To investigate real-world diagnosis and management strategies for acquired FXIII deficiency.
- To analyze treatment outcomes in patients with postsurgical bleeding and wound healing disorders (WHD).
Main Methods:
- Retrospective data collection from adult patients undergoing FXIII activity testing and supplementation.
- Analysis of treatment outcomes in postsurgical bleeding and WHD cohorts.
Main Results:
- 84% of 255 patients diagnosed with clinically relevant FXIII deficiency; 77% received FXIII supplementation.
- Clinically relevant deficiency often identified below 60% FXIII activity.
- Conventional coagulation tests were often normal, indicating a diagnostic gap.
Conclusions:
- FXIII supplementation frequently initiated at FXIII activity levels below 60%-70%.
- Consider FXIII testing for unexplained bleeding or impaired wound healing, especially perioperatively or with infections.
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