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European Journal of Trauma and Emergency Surgery

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Open Access 21-01-2023 | Original Article

The potential impact of coagulation factor XIII in trauma-induced coagulopathy – a retrospective case series analysis

Authors: Michaela Wilhelmi, Alexander Albrecht, Christian Macke, Mathias Wilhelmi, Mohammed Omar, Marcel Winkelmann, Jan-Dierk Clausen

Published in: European Journal of Trauma and Emergency Surgery | Issue 3/2023

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.

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Title: The potential impact of coagulation factor XIII in trauma-induced coagulopathy – a retrospective case series analysis
Authors: Michaela Wilhelmi
Alexander Albrecht
Christian Macke
Mathias Wilhelmi
Mohammed Omar
Marcel Winkelmann
Jan-Dierk Clausen
Publication date: 21-01-2023
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Trauma and Emergency Surgery / Issue 3/2023
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-023-02221-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The potential impact of coagulation factor XIII in trauma-induced coagulopathy – a retrospective case series analysis

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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