Abstract Number: PB0095
Meeting: ISTH 2021 Congress
Background: In trauma patients, trauma-induced coagulopathy (TIC) is a leading cause of mortality. Fibrin monomers (FM) and fibrinogen are markers of coagulation activation. Therefore, we speculate that these markers can be potential predictors of mortality in trauma patients.
Aims: Evaluate the in-hospital mortality predictive value of early fibrin monomers and fibrinogen levels in severe trauma.
Methods: Trauma patients with Injury Severity Scores (ISS) > 15 were recruited. FM and fibrinogen levels were checked at admission and again after 24 hours (if the patient survived the first 24 hours.) The lowest FM and the highest fibrinogen values were defined as nadir FM (minFM) and peak fibrinogen levels (maxFib.) The patients were observed until being discharged from the hospital or dying during treatment.
Results: 19 patients were recruited in this preliminary study. 8 patients survived and 11 died in-hospital, Mean minFM and maxFib of the non-survivors were 122.92 ± 81.59 µg/ml and 2.74 ± 1.89 g/L, respectively. Mean minFM and maxFib of the survivors were 9.06 ± 4.98 µg/ml and 4.93 ± 1.43 g/L, respectively. Both minFM and maxFib were significantly different between survivors and non-survivors (p<0.05.) A minFM of >36.97 µg/ml had a sensitivity of 81.8% and specificity of 100% for in-hospital mortality prediction. A maxFib of < 4.56 g/L had a sensitivity of 72.7% and specificity of 87.5% for in-hospital mortality prediction.
Conclusions: Our results highlight the role of coagulopathy in trauma. More specifically, since both FM and fibrinogen are very sensitive markers of fibrinolysis, we hypothesize that hyperfibrinolysis is the main etiology of TIC. Therefore, close monitoring of hyperfibrinolysis with assays like FM or fibrinogen levels may be crucial in trauma management. Further studies are warranted to clarify the roles of these assay in the clinical setting.
To cite this abstract in AMA style:Nguyen T, Tran N, Tran T, Nguyen D, Thang N, Nguyen T, Tran T. Ability of Fibrin Monomers and Fibrinogen Levels to Predict In-hospital Mortality in Patients with Severe Trauma [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 2). https://abstracts.isth.org/abstract/ability-of-fibrin-monomers-and-fibrinogen-levels-to-predict-in-hospital-mortality-in-patients-with-severe-trauma/. Accessed December 11, 2023.
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