Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Mar 24;8(4):16.
doi: 10.3390/medicines8040016.

Trauma-Induced Coagulopathy: Overview of an Emerging Medical Problem from Pathophysiology to Outcomes

Gabriele Savioli  1 , Iride Francesca Ceresa  1 , Luca Caneva  2 , Sebastiano Gerosa  1 , Giovanni Ricevuti  3   4
Affiliations
Review

Trauma-Induced Coagulopathy: Overview of an Emerging Medical Problem from Pathophysiology to Outcomes

Gabriele Savioli et al. Medicines (Basel). .

Abstract

Coagulopathy induced by major trauma is common, affecting approximately one-third of patients after trauma. It develops independently of iatrogenic, hypothermic, and dilutive causes (such as iatrogenic cause in case of fluid administration), which instead have a pejorative aspect on coagulopathy. Notwithstanding the continuous research conducted over the past decade on Trauma-Induced Coagulopathy (TIC), it remains a life-threatening condition with a significant impact on trauma mortality. We reviewed the current evidence regarding TIC diagnosis and pathophysiological mechanisms and summarized the different iterations of optimal TIC management strategies among which product resuscitation, potential drug administrations, and hemostatis-focused approaches. We have identified areas of ongoing investigation and controversy in TIC management.

Keywords: acute coagulopathy of trauma-shock; acute traumatic coagulopathy; early coagulopathy of trauma; major trauma; severe trauma; trauma-associated coagulopathy; trauma-induced coagulopathy.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Lethal triad for major trauma.
Figure 2
Figure 2
Factors involved in the development of trauma-induced cardiomyopathy.
Figure 3
Figure 3
Role of protein C.
Figure 4
Figure 4
Role of the neurohumoral system.
Figure 5
Figure 5
Overview of the mechanisms of trauma-induced coagulopathy (TIC).
Figure 6
Figure 6
Overview of hints for therapy.
See this image and copyright information in PMC

References

    1. Department of Violence and Injury Prevention and Disability. World Health Organization Injuries and Violence: The Facts. [(accessed on 22 February 2020)]; Available online: http://whqlibdoc.who.int/publications/2010/9789241599375_eng.pdf.
    1. GBD 2013 Mortality and Causes of Death Collaborators Global, regional, and national age–sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: A systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2014;385:117–171. doi: 10.1016/S0140-6736(14)61682-2. - DOI - PMC - PubMed
    1. Soreide K. Epidemiology of major trauma. Br. J. Surg. 2009;96:697–698. doi: 10.1002/bjs.6643. - DOI - PubMed
    1. Frith D., Goslings J.C., Gaarder C., Maegele M., Cohen M.J., Allard S., Johansson P.I., Stanworth S., Thiemermann C., Brohi K. Definition and drivers of acute traumatic coagulopathy: Clinical and experimental investigations. J. Thromb. Haemost. 2010;8:1919–1925. doi: 10.1111/j.1538-7836.2010.03945.x. - DOI - PubMed
    1. Maegele M., Lefering R., Yucel N., Tjardes T., Rixen D., Paffrath T., Simanski C., Neugebauer E., Bouillon B. Early coagulopathy in multiple injury: An analysis from the German Trauma Registry on 8724 patients. Injury. 2007;38:298–304. doi: 10.1016/j.injury.2006.10.003. - DOI - PubMed

LinkOut - more resources