Citation

Prior SM, Park MS, Mann KG, Butenas S. TH Open 2019; 3(1): e10-e19.

Affiliation

Department of Biochemistry, University of Vermont, Colchester, Vermont, United States.

Copyright

(Copyright © 2019, Thieme)

DOI

10.1055/s-0038-1677030

PMID

31249976

PMCID

PMC6524897

Abstract

Background  It has been observed that trauma patients have elevated plasma procoagulant activity that could be assigned to an elevated concentration of tissue factor (TF). However, in many instances there is a discrepancy between the levels of TF and the procoagulant activity observed. We hypothesized that factor XIa (FXIa) could be responsible for this additional activity and that the presence and levels of both proteins could correlate with trauma severity. Methods  Citrate plasma from 98 trauma patients (47 blunt, 17 penetrating, and 34 thermal) were evaluated in clotting assays for the presence of FXIa and TF activity using respective inhibitory antibodies. Results  When the three trauma patient groups were divided into two cohorts (Injury Severity Score [ISS] > 25 and ISS ≤ 25), higher frequencies and concentrations of both TF and FXIa were observed for all the more severe injury subgroups. Conclusions  The majority of trauma patients have active FXIa in their plasma, with a significant fraction having active TF as well. Additionally, both TF and FXIa frequency and concentration directly relate to trauma severity. These data suggest the use of these two proteins as potential markers for the stratification of trauma patients.

Language: en

Keywords

factor XIa activity; markers of trauma; severity of trauma; tissue factor activity