First Place Residents' Competition: Trauma induces a hypercoagulable state that is resistant to hypothermia as measured by thrombelastogram

Jerome A. Differding, Samantha J. Underwood, Philbert Y. Van, Rakan A. Khaki, Nicholas J. Spoerke, Martin A. Schreiber

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Background: The aim of this study was to test the hypothesis that severely injured trauma patients would be hypercoagulable compared with controls measured by thromboelastography and that this hypercoagulability would persist over a broad range of temperatures. Methods: A prospective study evaluating the effects of temperature on coagulation in trauma patients with Injury Severity Scores ≥ 15 and controls was completed. Thromboelastography was performed 24 hours after admission at 4 temperatures ranging from 32°C to 38°C. Results: Ninety-two subjects (46 patients) were analyzed. Patients had a median Injury Severity Score of 20 (interquartile range, 16-26). Time to clot formation increased (P < .001) and fibrin cross-linking decreased (P < .01) in both groups as temperature decreased. Between groups, time to clot formation, fibrin cross-linking, and clot strength were significantly different at each temperature (P < .01), with patients being more hypercoagulable. Time to clot formation and fibrin cross-linking were more affected by temperature in controls compared with patients (P < .02). Conclusions: Severely injured patients are more hypercoagulable than controls throughout a broad range of temperature. Decreasing temperature has a greater effect on coagulation in controls compared with patients.

Original languageEnglish (US)
Pages (from-to)585-589
Number of pages5
JournalAmerican journal of surgery
Volume201
Issue number5
DOIs
StatePublished - May 2011

Keywords

  • Hypercoagulable
  • Hypothermia
  • Thromboelastography
  • Trauma

ASJC Scopus subject areas

  • Surgery

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