The potential impact of coagulation factor XIII in trauma-induced coagulopathy – a retrospective case series analysis
Background The role of factor XIII (FXIII) in trauma-induced coagulopathy (TIC) is not fully understood. Methods We evaluated FXIII supplementation in severely injured patients with persistent bleeding. This was a retrospective case series analysis. Results Twenty-four patients received FXIII concen...
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| Veröffentlicht in: | European journal of trauma and emergency surgery (Munich : 2007) 2023-06, Vol.49 (3), p.1517-1523 |
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| creator | Wilhelmi, Michaela Albrecht, Alexander Macke, Christian Wilhelmi, Mathias Omar, Mohammed Winkelmann, Marcel Clausen, Jan-Dierk |
| description | Background
The role of factor XIII (FXIII) in trauma-induced coagulopathy (TIC) is not fully understood.
Methods
We evaluated FXIII supplementation in severely injured patients with persistent bleeding. This was a retrospective case series analysis.
Results
Twenty-four patients received FXIII concentrate within 24 h of admission for bleeding that continued after transfusion of > 6 U red blood cells (RBCs); control patients (
n
= 27) did not receive FXIII concentrate. Both study groups were similar regarding injury severity score and global coagulation tests, but FXIII activity levels were significantly higher and lactate levels significantly lower in the control group, respectively. The differences in FXIII activity between the groups could be attributed to a more severe trauma-induced coagulopathy in FXIII-deficient patients, as demonstrated by lower fibrinogen and higher lactate levels. The median dose of FXIII concentrate within 24 h of admission was 2500 IU (IQR: 1250–4375). Median 24-h transfusion of RBCs (primary study endpoint) was significantly higher in the FXIII group versus controls (10.0 U, IQR 5–14 U vs. 2, IQR 0–6 U;
p
|
| doi_str_mv | 10.1007/s00068-023-02221-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_10229685</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2820813684</sourcerecordid><originalsourceid>FETCH-LOGICAL-c426t-e54d2605d9a8936c22c5aaba60389ad24581ae10737cbfacabe01bd9c8e2892b3</originalsourceid><addsrcrecordid>eNp9kctu1DAUhq0KRC_wAl0gS2y6CfiSOM6qQhUtI1ViUyR21olzZsZVEqe2UzRd9R36hjwJhhmGy4KFZcvnO_-5_ISccvaWM1a_i4wxpQsmZD5C8OLhgBxxrWTRNCV_tn9LeUiOY7zNNFOVeEEOpVI1k0weka83a6STTzgmBz11wwQ2Ub-k1sNq7iE5P9Jl_vOBflksFtSNNAWYByjc2M0Wux3pJ0jrDf32-ESBBkzBxwltcvdILUSkEYPDSGGEfhNdfEmeL6GP-Gp3n5DPlx9uLj4W15-uFhfvrwtbCpUKrMpOKFZ1DehGKiuErQBaUEzqBjpRVpoDclbL2ra5TWiR8bZrrEahG9HKE3K-1Z3mdsDO5jkD9GYKboCwMR6c-TsyurVZ-XvD80obpauscLZTCP5uxpjM4KLFvocR_RyNqJUWZVlLndE3_6C3fg554kxpwTSXSpeZElvK5h3FgMt9N5yZH8aarbEmG2t-GmsectLrP-fYp_xyMgNyC8QcGlcYftf-j-x3s0OyZA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2820813684</pqid></control><display><type>article</type><title>The potential impact of coagulation factor XIII in trauma-induced coagulopathy – a retrospective case series analysis</title><source>SpringerLink Journals - AutoHoldings</source><creator>Wilhelmi, Michaela ; Albrecht, Alexander ; Macke, Christian ; Wilhelmi, Mathias ; Omar, Mohammed ; Winkelmann, Marcel ; Clausen, Jan-Dierk</creator><creatorcontrib>Wilhelmi, Michaela ; Albrecht, Alexander ; Macke, Christian ; Wilhelmi, Mathias ; Omar, Mohammed ; Winkelmann, Marcel ; Clausen, Jan-Dierk</creatorcontrib><description>Background
The role of factor XIII (FXIII) in trauma-induced coagulopathy (TIC) is not fully understood.
Methods
We evaluated FXIII supplementation in severely injured patients with persistent bleeding. This was a retrospective case series analysis.
Results
Twenty-four patients received FXIII concentrate within 24 h of admission for bleeding that continued after transfusion of > 6 U red blood cells (RBCs); control patients (
n
= 27) did not receive FXIII concentrate. Both study groups were similar regarding injury severity score and global coagulation tests, but FXIII activity levels were significantly higher and lactate levels significantly lower in the control group, respectively. The differences in FXIII activity between the groups could be attributed to a more severe trauma-induced coagulopathy in FXIII-deficient patients, as demonstrated by lower fibrinogen and higher lactate levels. The median dose of FXIII concentrate within 24 h of admission was 2500 IU (IQR: 1250–4375). Median 24-h transfusion of RBCs (primary study endpoint) was significantly higher in the FXIII group versus controls (10.0 U, IQR 5–14 U vs. 2, IQR 0–6 U;
p
< 0.01). Subsequently, while patients were in the intensive care unit, there was no statistically significant difference regarding RBC transfusion anymore and the overall clinical outcomes were similar in both patient groups.
Conclusions
The substitution of FXIII in patients who were more seriously compromised due to higher lactate levels and who presented with initially more severe bleedings than patients in the control group, resulted in a comparable transfusion necessity after 24 h. Thus, we guess that the substitution of FXIII in severely injured patients with ongoing bleeding might have an impact on their clinical outcome.</description><identifier>ISSN: 1863-9933</identifier><identifier>EISSN: 1863-9941</identifier><identifier>DOI: 10.1007/s00068-023-02221-z</identifier><identifier>PMID: 36670303</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Blood ; Blood platelets ; Coagulation ; Critical Care Medicine ; Emergency Medicine ; Intensive ; Intensive care ; Length of stay ; Medicine ; Medicine & Public Health ; Original ; Original Article ; Patients ; Sports Medicine ; Surgery ; Surgical Orthopedics ; Trauma ; Traumatic Surgery</subject><ispartof>European journal of trauma and emergency surgery (Munich : 2007), 2023-06, Vol.49 (3), p.1517-1523</ispartof><rights>The Author(s) 2023</rights><rights>2023. The Author(s).</rights><rights>The Author(s) 2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c426t-e54d2605d9a8936c22c5aaba60389ad24581ae10737cbfacabe01bd9c8e2892b3</cites><orcidid>0000-0001-7814-6526</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00068-023-02221-z$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00068-023-02221-z$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,27903,27904,41467,42536,51297</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36670303$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Wilhelmi, Michaela</creatorcontrib><creatorcontrib>Albrecht, Alexander</creatorcontrib><creatorcontrib>Macke, Christian</creatorcontrib><creatorcontrib>Wilhelmi, Mathias</creatorcontrib><creatorcontrib>Omar, Mohammed</creatorcontrib><creatorcontrib>Winkelmann, Marcel</creatorcontrib><creatorcontrib>Clausen, Jan-Dierk</creatorcontrib><title>The potential impact of coagulation factor XIII in trauma-induced coagulopathy – a retrospective case series analysis</title><title>European journal of trauma and emergency surgery (Munich : 2007)</title><addtitle>Eur J Trauma Emerg Surg</addtitle><addtitle>Eur J Trauma Emerg Surg</addtitle><description>Background
The role of factor XIII (FXIII) in trauma-induced coagulopathy (TIC) is not fully understood.
Methods
We evaluated FXIII supplementation in severely injured patients with persistent bleeding. This was a retrospective case series analysis.
Results
Twenty-four patients received FXIII concentrate within 24 h of admission for bleeding that continued after transfusion of > 6 U red blood cells (RBCs); control patients (
n
= 27) did not receive FXIII concentrate. Both study groups were similar regarding injury severity score and global coagulation tests, but FXIII activity levels were significantly higher and lactate levels significantly lower in the control group, respectively. The differences in FXIII activity between the groups could be attributed to a more severe trauma-induced coagulopathy in FXIII-deficient patients, as demonstrated by lower fibrinogen and higher lactate levels. The median dose of FXIII concentrate within 24 h of admission was 2500 IU (IQR: 1250–4375). Median 24-h transfusion of RBCs (primary study endpoint) was significantly higher in the FXIII group versus controls (10.0 U, IQR 5–14 U vs. 2, IQR 0–6 U;
p
< 0.01). Subsequently, while patients were in the intensive care unit, there was no statistically significant difference regarding RBC transfusion anymore and the overall clinical outcomes were similar in both patient groups.
Conclusions
The substitution of FXIII in patients who were more seriously compromised due to higher lactate levels and who presented with initially more severe bleedings than patients in the control group, resulted in a comparable transfusion necessity after 24 h. Thus, we guess that the substitution of FXIII in severely injured patients with ongoing bleeding might have an impact on their clinical outcome.</description><subject>Blood</subject><subject>Blood platelets</subject><subject>Coagulation</subject><subject>Critical Care Medicine</subject><subject>Emergency Medicine</subject><subject>Intensive</subject><subject>Intensive care</subject><subject>Length of stay</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original</subject><subject>Original Article</subject><subject>Patients</subject><subject>Sports Medicine</subject><subject>Surgery</subject><subject>Surgical Orthopedics</subject><subject>Trauma</subject><subject>Traumatic Surgery</subject><issn>1863-9933</issn><issn>1863-9941</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp9kctu1DAUhq0KRC_wAl0gS2y6CfiSOM6qQhUtI1ViUyR21olzZsZVEqe2UzRd9R36hjwJhhmGy4KFZcvnO_-5_ISccvaWM1a_i4wxpQsmZD5C8OLhgBxxrWTRNCV_tn9LeUiOY7zNNFOVeEEOpVI1k0weka83a6STTzgmBz11wwQ2Ub-k1sNq7iE5P9Jl_vOBflksFtSNNAWYByjc2M0Wux3pJ0jrDf32-ESBBkzBxwltcvdILUSkEYPDSGGEfhNdfEmeL6GP-Gp3n5DPlx9uLj4W15-uFhfvrwtbCpUKrMpOKFZ1DehGKiuErQBaUEzqBjpRVpoDclbL2ra5TWiR8bZrrEahG9HKE3K-1Z3mdsDO5jkD9GYKboCwMR6c-TsyurVZ-XvD80obpauscLZTCP5uxpjM4KLFvocR_RyNqJUWZVlLndE3_6C3fg554kxpwTSXSpeZElvK5h3FgMt9N5yZH8aarbEmG2t-GmsectLrP-fYp_xyMgNyC8QcGlcYftf-j-x3s0OyZA</recordid><startdate>20230601</startdate><enddate>20230601</enddate><creator>Wilhelmi, Michaela</creator><creator>Albrecht, Alexander</creator><creator>Macke, Christian</creator><creator>Wilhelmi, Mathias</creator><creator>Omar, Mohammed</creator><creator>Winkelmann, Marcel</creator><creator>Clausen, Jan-Dierk</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>C6C</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0001-7814-6526</orcidid></search><sort><creationdate>20230601</creationdate><title>The potential impact of coagulation factor XIII in trauma-induced coagulopathy – a retrospective case series analysis</title><author>Wilhelmi, Michaela ; Albrecht, Alexander ; Macke, Christian ; Wilhelmi, Mathias ; Omar, Mohammed ; Winkelmann, Marcel ; Clausen, Jan-Dierk</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c426t-e54d2605d9a8936c22c5aaba60389ad24581ae10737cbfacabe01bd9c8e2892b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Blood</topic><topic>Blood platelets</topic><topic>Coagulation</topic><topic>Critical Care Medicine</topic><topic>Emergency Medicine</topic><topic>Intensive</topic><topic>Intensive care</topic><topic>Length of stay</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original</topic><topic>Original Article</topic><topic>Patients</topic><topic>Sports Medicine</topic><topic>Surgery</topic><topic>Surgical Orthopedics</topic><topic>Trauma</topic><topic>Traumatic Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wilhelmi, Michaela</creatorcontrib><creatorcontrib>Albrecht, Alexander</creatorcontrib><creatorcontrib>Macke, Christian</creatorcontrib><creatorcontrib>Wilhelmi, Mathias</creatorcontrib><creatorcontrib>Omar, Mohammed</creatorcontrib><creatorcontrib>Winkelmann, Marcel</creatorcontrib><creatorcontrib>Clausen, Jan-Dierk</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>European journal of trauma and emergency surgery (Munich : 2007)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Wilhelmi, Michaela</au><au>Albrecht, Alexander</au><au>Macke, Christian</au><au>Wilhelmi, Mathias</au><au>Omar, Mohammed</au><au>Winkelmann, Marcel</au><au>Clausen, Jan-Dierk</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The potential impact of coagulation factor XIII in trauma-induced coagulopathy – a retrospective case series analysis</atitle><jtitle>European journal of trauma and emergency surgery (Munich : 2007)</jtitle><stitle>Eur J Trauma Emerg Surg</stitle><addtitle>Eur J Trauma Emerg Surg</addtitle><date>2023-06-01</date><risdate>2023</risdate><volume>49</volume><issue>3</issue><spage>1517</spage><epage>1523</epage><pages>1517-1523</pages><issn>1863-9933</issn><eissn>1863-9941</eissn><abstract>Background
The role of factor XIII (FXIII) in trauma-induced coagulopathy (TIC) is not fully understood.
Methods
We evaluated FXIII supplementation in severely injured patients with persistent bleeding. This was a retrospective case series analysis.
Results
Twenty-four patients received FXIII concentrate within 24 h of admission for bleeding that continued after transfusion of > 6 U red blood cells (RBCs); control patients (
n
= 27) did not receive FXIII concentrate. Both study groups were similar regarding injury severity score and global coagulation tests, but FXIII activity levels were significantly higher and lactate levels significantly lower in the control group, respectively. The differences in FXIII activity between the groups could be attributed to a more severe trauma-induced coagulopathy in FXIII-deficient patients, as demonstrated by lower fibrinogen and higher lactate levels. The median dose of FXIII concentrate within 24 h of admission was 2500 IU (IQR: 1250–4375). Median 24-h transfusion of RBCs (primary study endpoint) was significantly higher in the FXIII group versus controls (10.0 U, IQR 5–14 U vs. 2, IQR 0–6 U;
p
< 0.01). Subsequently, while patients were in the intensive care unit, there was no statistically significant difference regarding RBC transfusion anymore and the overall clinical outcomes were similar in both patient groups.
Conclusions
The substitution of FXIII in patients who were more seriously compromised due to higher lactate levels and who presented with initially more severe bleedings than patients in the control group, resulted in a comparable transfusion necessity after 24 h. Thus, we guess that the substitution of FXIII in severely injured patients with ongoing bleeding might have an impact on their clinical outcome.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>36670303</pmid><doi>10.1007/s00068-023-02221-z</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-7814-6526</orcidid><oa>free_for_read</oa></addata></record> |
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| language | eng |
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| subjects | Blood Blood platelets Coagulation Critical Care Medicine Emergency Medicine Intensive Intensive care Length of stay Medicine Medicine & Public Health Original Original Article Patients Sports Medicine Surgery Surgical Orthopedics Trauma Traumatic Surgery |
| title | The potential impact of coagulation factor XIII in trauma-induced coagulopathy – a retrospective case series analysis |
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