Fibrinolytic Activation and Its Association with Mortality After Traumatic and Thermal Injury.

IF 2.7 3区医学 Q2 CRITICAL CARE MEDICINE

SHOCK Pub Date : 2026-10-13 DOI:10.1097/SHK.0000000000002948

Amanda M Soo Ping Chow, Tuan D Le, Desiree N Pinto, Melissa McLawhorn, Lauren T Moffatt, Thomas Orfeo, Kalev Freeman, Rachael A Callcut, Mitchell J Cohen, Jeffrey W Shupp, Anthony E Pusateri

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引用次数: 0

Abstract

Objective: Characterize plasma markers of fibrinolytic activation and their associations with mortality in burn and trauma patients from hospital admission through 48 hours.

Summary background information: Fibrinolytic activation following burn and non-burn trauma is associated with increased mortality. Whether fibrinolytic activation differs between burn and non-burn injury is unknown.

Methods: Adult patients aged 18 years and older who presented to one of two regional trauma centers or one regional burn center within 4 hours of injury were included. Blood was collected at admission and at hours 2, 4, 6, 8, 12, 24, 36, and 48. Plasmin-antiplasmin complex (PAP), D-dimer, and plasminogen concentrations in plasma were determined.

Results: Of 590 patients, 58.3% presented with blunt, 27.1% with thermal, and 14.6% with penetrating injury. Admission PAP and D-dimer were higher in trauma (blunt and penetrating groups combined) than in burn patients (p<.001). Non-survivors (injury types combined) had higher PAP and D-dimer and lower plasminogen (p<.001) at admission and over time. After adjusting for age, injury severity and % total body surface area burned, admission PAP ≥1645.6 ng/mL was associated with 7.0 times higher odds for mortality (p=.002) and D-dimer ≥6.5 µg/mL was associated with 5.0 times higher odds for mortality (p=.01). Changes in biomarkers over time were similar between trauma and burn patients.

Conclusions: Higher fibrinolytic activation was associated with mortality in trauma and burn patients. Trauma patients had higher fibrinolytic activation markers than burn patients, while patterns of change were similar. Data suggest potential for use of similar resuscitative adjuncts to mitigate early fibrinolytic dysfunction in trauma and burns.

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纤维蛋白溶解激活及其与创伤和热损伤后死亡率的关系。

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来源期刊

SHOCK 医学-外科

CiteScore

6.20

自引率

3.20%

发文量

199

审稿时长

1 months

期刊介绍： SHOCK®: Injury, Inflammation, and Sepsis: Laboratory and Clinical Approaches includes studies of novel therapeutic approaches, such as immunomodulation, gene therapy, nutrition, and others. The mission of the Journal is to foster and promote multidisciplinary studies, both experimental and clinical in nature, that critically examine the etiology, mechanisms and novel therapeutics of shock-related pathophysiological conditions. Its purpose is to excel as a vehicle for timely publication in the areas of basic and clinical studies of shock, trauma, sepsis, inflammation, ischemia, and related pathobiological states, with particular emphasis on the biologic mechanisms that determine the response to such injury. Making such information available will ultimately facilitate improved care of the traumatized or septic individual.