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Factor XIII Measurement and Substitution in Trauma Patients after Admission to an Intensive Care Unit
Trauma patients admitted to an intensive care unit (ICU) may potentially experience a deficiency of coagulation factor thirteen (FXIII). In this retrospective cohort study conducted at a specialized trauma center, ICU patients were studied to determine the dependency of FXIII activity levels on clin...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9317588/ https://www.ncbi.nlm.nih.gov/pubmed/35887938 http://dx.doi.org/10.3390/jcm11144174 |
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author | Katzensteiner, Moritz Ponschab, Martin Schöchl, Herbert Oberladstätter, Daniel Zipperle, Johannes Osuchowski, Marcin Schlimp, Christoph J. |
author_facet | Katzensteiner, Moritz Ponschab, Martin Schöchl, Herbert Oberladstätter, Daniel Zipperle, Johannes Osuchowski, Marcin Schlimp, Christoph J. |
author_sort | Katzensteiner, Moritz |
collection | PubMed |
description | Trauma patients admitted to an intensive care unit (ICU) may potentially experience a deficiency of coagulation factor thirteen (FXIII). In this retrospective cohort study conducted at a specialized trauma center, ICU patients were studied to determine the dependency of FXIII activity levels on clinical course and substitution with blood and coagulation products. A total of 189 patients with a median injury severity score (ISS) of 25 (16–36, IQR) were included. Abbreviated injury scores for extremities (r = −0.38, p < 0.0001) but not ISS (r = −0.03, p = 0.45) showed a negative correlation with initial FXIII levels. Patients receiving FXIII concentrate presented with a median initial FXIII level of 54 (48–59)% vs. 88 (74–108)%, p < 0.0001 versus controls; they had fewer ICU-free days: 17 (0–22) vs. 22 (16–24), p = 0.0001; and received higher amounts of red blood cell units: 5 (2–9) vs. 4 (1–7), p < 0.03 before, and 4 (2–7) vs. 1 (0–2), p < 0.0001 after FXIII substitution. Matched-pair analyses based on similar initial FXIII levels did not reveal better outcome endpoints in the FXIII-substituted group. The study showed that a low initial FXIII level correlated with the clinical course in this trauma cohort, but a substitution of FXIII did not improve endpoints within the range of the studied FXIII levels. Future prospective studies should investigate the utility of FXIII measurement and lower threshold values of FXIII, which trigger substitution in trauma patients. |
format | Online Article Text |
id | pubmed-9317588 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-93175882022-07-27 Factor XIII Measurement and Substitution in Trauma Patients after Admission to an Intensive Care Unit Katzensteiner, Moritz Ponschab, Martin Schöchl, Herbert Oberladstätter, Daniel Zipperle, Johannes Osuchowski, Marcin Schlimp, Christoph J. J Clin Med Article Trauma patients admitted to an intensive care unit (ICU) may potentially experience a deficiency of coagulation factor thirteen (FXIII). In this retrospective cohort study conducted at a specialized trauma center, ICU patients were studied to determine the dependency of FXIII activity levels on clinical course and substitution with blood and coagulation products. A total of 189 patients with a median injury severity score (ISS) of 25 (16–36, IQR) were included. Abbreviated injury scores for extremities (r = −0.38, p < 0.0001) but not ISS (r = −0.03, p = 0.45) showed a negative correlation with initial FXIII levels. Patients receiving FXIII concentrate presented with a median initial FXIII level of 54 (48–59)% vs. 88 (74–108)%, p < 0.0001 versus controls; they had fewer ICU-free days: 17 (0–22) vs. 22 (16–24), p = 0.0001; and received higher amounts of red blood cell units: 5 (2–9) vs. 4 (1–7), p < 0.03 before, and 4 (2–7) vs. 1 (0–2), p < 0.0001 after FXIII substitution. Matched-pair analyses based on similar initial FXIII levels did not reveal better outcome endpoints in the FXIII-substituted group. The study showed that a low initial FXIII level correlated with the clinical course in this trauma cohort, but a substitution of FXIII did not improve endpoints within the range of the studied FXIII levels. Future prospective studies should investigate the utility of FXIII measurement and lower threshold values of FXIII, which trigger substitution in trauma patients. MDPI 2022-07-19 /pmc/articles/PMC9317588/ /pubmed/35887938 http://dx.doi.org/10.3390/jcm11144174 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Katzensteiner, Moritz Ponschab, Martin Schöchl, Herbert Oberladstätter, Daniel Zipperle, Johannes Osuchowski, Marcin Schlimp, Christoph J. Factor XIII Measurement and Substitution in Trauma Patients after Admission to an Intensive Care Unit |
title | Factor XIII Measurement and Substitution in Trauma Patients after Admission to an Intensive Care Unit |
title_full | Factor XIII Measurement and Substitution in Trauma Patients after Admission to an Intensive Care Unit |
title_fullStr | Factor XIII Measurement and Substitution in Trauma Patients after Admission to an Intensive Care Unit |
title_full_unstemmed | Factor XIII Measurement and Substitution in Trauma Patients after Admission to an Intensive Care Unit |
title_short | Factor XIII Measurement and Substitution in Trauma Patients after Admission to an Intensive Care Unit |
title_sort | factor xiii measurement and substitution in trauma patients after admission to an intensive care unit |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9317588/ https://www.ncbi.nlm.nih.gov/pubmed/35887938 http://dx.doi.org/10.3390/jcm11144174 |
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