Trauma-Induced Coagulopathy

Petros, Sirak

doi:10.1055/s-0039-1677853

Cited by 22 publications

(30 citation statements)

References 78 publications

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“…EG has the effects of inhibiting platelet adhesion on the endothelial surface, anti-microthrombosis and maintaining coagulationanticoagulant balance. Post-traumatic bleeding, in ammation and other factors lead to abnormal degradation of EG, which may participate in the TIC mechanism 26 . This study revealed SDC1 and HS were both correlated with blood loss and coagulation indexes including Hb, PLT, PT, APTT, AT-III and Ca 2+ .…”

Section: Discussionmentioning

confidence: 99%

“…The receiver operating characteristic (ROC) curves were graphed and area under the curve (AUC) were calculated to investigate the accuracy of indicators for predicting AKI, TIC within 48 hours, and 28-day mortality in trauma group. All statistical tests were two-tailed, and P < 0.05 was considered statistically signi cant.The trauma group had a median ISS of 24(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29). Main causes of trauma were tra c injuries and falling injuries (53.3% and 31.1%, respectively).…”

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confidence: 99%

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Endothelial Glycocalyx Degradation Is Associated With Early Organ Impairment in Multiple Trauma Patients

Zhou

et al. 2021

Preprint

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BackgroundEndothelial glycocalyx (EG) abnormal degradation were widely found in critical illness. However, data of EG degradation in multiple traumas is limited. We performed a study to assess the EG degradation and the correlation between the degradation and organ functions in multiple trauma patients. MethodsA prospective observational study was conducted to enroll health participants (control group) and multiple traumas patients (trauma group) at a University affiliated hospital between Feb 2020 and Oct 2020. Syndecan1 (SDC1) and heparin sulfate (HS) were detected in serum sample of both groups. In trauma group, injury severity scores (ISS) and sequential organ failure assessments (SOFA) were calculated. Occurrences of acute kidney injury (AKI), trauma-induced coagulopathy (TIC) within 48 hours and 28-day all-cause mortality in trauma group were recorded. Serum SDC1 and HS levels were compared between two groups. Correlations between SDC1/HS and the indicators of organ systems in the trauma group were analyzed. ROC analyses were performed to assess the predictive value of SDC1 and HS for AKI, TIC within 48 hours, and 28-day mortality in trauma group. ResultsThere were 45 multiple trauma patients and 15 healthy participants were collected, totally. SDC1 and HS were significantly higher in trauma group than in control group (69.39 [54.18–130.80] vs. 24.15 [13.89–32.36], 38.92 [30.47–67.96] vs. 15.55 [11.89–23.24], P<0.001, respectively). SDC1 and HS were both positively correlated with prothrombin time, activated partial thromboplastin time, EVLW, N-terminal pro-B-type natriuretic peptide, myoglobin, creatinine, lactic acid, interleukin-6, and tumor necrosis factor-α (P<0.05, respectively). SDC1 and HS were both negatively correlated with Ca2+, anti-thrombin-III, PaO2/FiO2 ratio, pH and albumin (P<0.05, respectively). Trauma group was divided into high degradation group and low degradation group according to SDC1 median. High degradation group had more severe ISS, SOFA scores, worse organ functions (respiratory, kidney, coagulation and metabolic system), and higher incidence of hypothermia, acidosis and shock. ROC curve analyses demonstrated SDC1 can predict the occurrence risk of AKI, TIC within 48h, and 28-day mortality. ConclusionsEG degradation was elevated significantly in multiple trauma patients, and the degradation was correlated with impaired respiratory, kidney, coagulation and metabolic systems. Serum SDC1 is a valuable predictive indicator of early TIC, AKI risk, and 28-day mortality in multiple trauma patients.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Endothelial Glycocalyx Degradation Is Associated With Early Organ Impairment in Multiple Trauma Patients

Zhou

et al. 2021

Preprint

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“…1 Acquired haemostatic disorders are being further addressed by Petros in his article on trauma-induced coagulopathy. 2 In recent years, we have learnt relevant details about the pathophysiology and treatment options of both entities.…”

Section: Dear Colleaguesmentioning

confidence: 99%

Science Meets Clinical Practice

Klamroth¹,

Koscielny²

2019

Hamostaseologie

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“…[ 2 ] Progressive trauma-induced coagulopathy is often manifested with increased microparticle and thrombin generation; these have been implicated in the pathogenesis of VTE and organ failure among high-risk populations. [ 3 4 ]…”

Section: Introductionmentioning

confidence: 99%

“…This huge disparity in the reported incidence is influenced by sociodemographic characteristics, nature of the injury, diagnostic modalities used, type and adherence to pharmacologic thromboprophylaxis. [ 3 5 ] Determining the true incidence of VTE and its associated consequences necessitates a thorough understanding of the underlying predisposing factors in trauma patients. Earlier studies have reported various risk factors for VTE in injured patients who require hospitalization.…”

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics, Management Practices, and In-hospital Outcomes among Trauma Patients with Venous Thromboembolism

Strandvik

El‐Menyar

Asim

et al. 2020

J Emerg Trauma Shock

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Background: We aimed to assess the clinical characteristics, management practices, and inhospital outcomes of venous thromboembolism (VTE) among trauma patients. Methods: A retrospective analysis of all trauma patients with documented venous thromboembolic events in a level 1 trauma center was conducted. Patients were categorized into two groups based on the primary initial presentation postinjury (deep-vein thrombosis [DVT] or pulmonary embolism [PE]). Results: Across the study period, a total of 662 patients were confirmed to have DVT and 258 patients were diagnosed with acute PE. Among them, 84 patients were identified to have trauma-associated VTE; 56 (8.5%) had DVT and 28 (10.9%) had PE. Two patients who initially presented with DVT developed PE on follow-up. There were 38 females and 46 males with a mean age of 46 ± 18 years. Abnormal coagulation profile was reported as 7 protein C deficiencies, 5 protein S deficiencies, 6 homocystinemia, 4 antithrombin III deficiency, 4 lupus anticoagulant, and 2 Factor V Leiden. Age, sex, obesity, D-dimer level, and treatment (except for heparin) were comparable between the two groups; whereas protein S deficiency, prior history of PE, bedridden status, congestive heart failure, and history of recent surgery, were more evident in the PE group. The incidence of postthrombotic syndrome was significantly higher in the DVT group. Overall mortality rate was 8.3% (DVT; 8.9% vs. PE; 7.1%, respectively = 0.78). Conclusion: Coagulation profile plays an important role in posttraumatic thromboembolic disease. A thorough assessment for features of thromboembolic disorders is warranted in polytrauma patients to avoid missing this potentially life-threatening diagnosis. Larger studies are needed for better understanding and management of VTE in trauma.

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Trauma-Induced Coagulopathy

Cited by 22 publications

References 78 publications

Endothelial Glycocalyx Degradation Is Associated With Early Organ Impairment in Multiple Trauma Patients

Endothelial Glycocalyx Degradation Is Associated With Early Organ Impairment in Multiple Trauma Patients

Science Meets Clinical Practice

Clinical Characteristics, Management Practices, and In-hospital Outcomes among Trauma Patients with Venous Thromboembolism

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