title: Hypercoagulability following multiple trauma.
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) > or = 16 (n = 36) had significantly elevated levels of D-dimer and decreased levels of functional protein C compared to patients with an ISS < or = 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.
authors.affiliation: Surgical Research Center, University of Connecticut School of Medicine, Farmington 06030-1110, USA.
authors.forename: D T
authors.initials: DT
authors.lastname: Engelman
authors.forename: S G
authors.initials: SG
authors.lastname: Gabram
authors.forename: L
authors.initials: L
authors.lastname: Allen
authors.forename: G E
authors.initials: GE
authors.lastname: Ens
authors.forename: L M
authors.initials: LM
authors.lastname: Jacobs
mesh_terms: D000328:Adult; D000368:Aged; D001777:Blood Coagulation; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000097:blood / Q000503:physiopathology*; D011446:Prospective Studies; D011486:Protein C / Q000032:analysis
chemical_list: D011486:Protein C