Objective. The aimof this study was to identify routinely available clinical surrogate markers for potential clotting factor alterations\nfollowing multiple trauma. Methods. In 68 patients admitted directly from the scene of the accident, all soluble clotting factors\nwere analyzed and clinical data was collected prospectively. Ten healthy subjects served as control group. Results. Patients showed\nreduced activities of clotting factors II, V, VII, and X and calcium levels (all P < 0.0001 to 0.01). Levels of hemoglobin and base\ndeficit correlated moderately to highly with the activities of a number of clotting factors. Nonsurvivors and patients who needed\npreclinical intubation or hemostatic therapy showed significantly reduced factor activities at admission. In contrast, factor VIII\nactivity was markedly elevated after injury in general (P < 0.0001), but reduced in nonsurvivors (P < 0.05). Conclusions. Multiple\ntrauma causes an early reduction of the activities of nearly all soluble clotting factors in general. Initial hemoglobin and, with\ncertain qualifications, base deficit levels demonstrated a potential value in detecting those underlying clotting factor deficiencies.\nNevertheless, their role as triggers of a hemostatic therapy as well as the observed response of factor VIII to multiple trauma and\nalso its potential prognostic value needs further evaluation.
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