Published: 2021-10-28

A prospective study to assess serum level of soluble thrombomodulin as early marker of acute traumatic coagulopathy in polytrauma patients

Ruby Kataria, M. Quamar Azam, Geeta Negi, Ajay Kumar, Bhaskar Sarkar, Madhur Uniyal


Background: Coagulopathy following major trauma is conventionally attributed to activation of coagulation factors. We hypothesized that early coagulopathy is due to tissue hypoperfusion and investigated thrombomodulin (TM) as early marker of endothelial injury in poly trauma patient.

Methods: This was a prospective cohort study of major trauma patients admitted to a single trauma center. Blood was drawn within 10 minutes of arrival for analysis of TM. We assess its association with blood transfusion, length of hospital stays and mortality.

Results: A total of 90 patients were enrolled. An increasing lactate was associated with high soluble TM. High TM was significantly associated with increased mortality, blood transfusion requirements, hospital stay.

Conclusions: Acute traumatic coagulopathy (ATC) occurs only in the presence of tissue hypoperfusion which we have measured in form of lactate and coagulopathy measured using international normalized ratio (INR) as standard. Admission serum TM can be predictive of clinical outcomes following major trauma.


ATC, Serum TM, Polytrauma, Blood transfusion, Lactate

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