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Hypercoagulability following multiple trauma

D T Engelman1, S G Gabram, L Allen

  • 1Surgical Research Center, University of Connecticut School of Medicine, Farmington 06030-1110, USA.

World Journal of Surgery
|January 1, 1996
PubMed
Summary
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Severe trauma patients often exhibit hypercoagulability, a state of increased blood clotting. This study found 85% of patients showed signs, with severe injuries linked to worse clotting factors like functional protein C.

Area of Science:

  • Trauma and Emergency Medicine
  • Hematology
  • Coagulation Science

Background:

  • Hypercoagulability, an increased tendency for blood to clot, is a potential complication in severely injured patients.
  • Understanding the immediate coagulation status post-trauma is crucial for patient management and outcomes.

Purpose of the Study:

  • To investigate the presence and extent of hypercoagulability in seriously injured trauma patients.
  • To examine the relationship between injury severity and specific coagulation markers.

Main Methods:

  • An extended coagulation profile was performed on 59 trauma patients.
  • Coagulation markers including D-dimer and functional protein C were assessed.
  • Results were compared to control values and stratified by Injury Severity Score (ISS).

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Main Results:

  • Laboratory evidence of hypercoagulability was observed in 85% of patients.
  • Patients with higher ISS (>= 16) showed significantly elevated D-dimer and decreased functional protein C.
  • Functional protein C levels negatively correlated with ISS (r = -0.44, p < 0.001).

Conclusions:

  • A hypercoagulable state is present immediately following severe trauma.
  • Increased injury severity appears to exacerbate the hypercoagulable state.
  • Decreased functional protein C levels are strongly associated with greater injury severity.