Abstract. We sought evidence of hypercoagulability in 59 seriously injured trauma patients. An extended coagulation profile (consisting of tissue plasminogen activator antigen concentration, plasminogen activator inhibitor, serum antithrombin III, protein C antigen, functional protein C, protein S antigen, D-dimer, and prothrombin fragment 1.2) was compared to control values. Laboratory evidence of hypercoagulability was seen in 85% (
n = 50) of the patients. Patients with an Injury Severity Score (ISS) ≥ 16 ( n = 36) had significantly elevated levels of D-dimer and decreased levels of functional protein C compared to patients with an ISS ≤ 15 ( n = 23). Functional protein C had a negative correlation ( r =−0.44; p < 0.001) with the ISS. A hypercoagulable state exists immediately following severe trauma. Greater injury severity may increase this hypercoagulable state. Decreased levels of functional protein C best correlated with increased injury severity.
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Engelman, D., Gabram, S., Allen, L. et al. Hypercoagulability following Multiple Trauma. World J. Surg. 20, 5–10 (1996). https://doi.org/10.1007/s002689900001
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DOI: https://doi.org/10.1007/s002689900001