The significance of the levels of fibrin/fibrinogen degradation products for predicting trauma severity

Abstract

Background: On initial treatment in the emergency room, trauma patients should be assessed using simple clinical indicators that can be measured quickly. Objectives: The purpose of this study is to investigate the relationship between the injury severity score and blood test parameters measured on emergency room arrival in trauma patients. Methods: Trauma patients transferred to Gunma University Hospital between May 2013 and April 2014 were evaluated in this prospective, observational study. Blood samples were collected immediately on their arrival at our emergency room and their hematocrit, platelet, international normalized ratio of prothrombin time, activated partial thromboplastin time, fibrin/fibrinogen degradation products, and D-dimer were measured. We evaluated the correlations between the injury severity score and those biomarkers, and examined whether the correlation varied according to the injury severity score value. We also evaluated the correlations between the biomarkers and the abbreviated injury scale values of six regions. Results: We analyzed 371 patients. Fibrin/fibrinogen degradation products and D-dimer showed the greatest coefficients of correlation with injury severity score (0.556 and 0.543, respectively). The area under the curve of the receiver operating characteristic was larger in patients with injury severity score ⩾ 9 than in those with injury severity score ⩾ 4; however, patients with injury severity score ⩾ 9 or ⩾16 showed no significant differences. The area under the curve of fibrin/fibrinogen degradation products was larger than that of D-dimer at all injury severity score values. The chest abbreviated injury scale had the strongest relationship with fibrin/fibrinogen degradation products. Conclusion: Fibrin/fibrinogen degradation products and D-dimer were positively correlated with injury severity score, and the relationships varied according to trauma severity. Chest trauma contributed most strongly to fibrin/fibrinogen degradation product elevation.

Plasma levels of D-dimer and fibrin degradation products correlate with bullous pemphigoid severity: a cross-sectional study

“…It is no surprise that D-dimer/FDP levels were increased in treatment-resistant patients but decreased in treatment responsive patients. Interestingly, we found that FDP levels are associated with urticaria/erythema in BP, which may occur for several reasons: (1) FDP can increase the vascular permeability and thereby induce wheals 23 ; (2) FDP can initiate thrombin-dependent activation of mast cells 24 ; (3) the urticaria/erythema associated with anti-BP180 IgE autoantibodies may increase the FDP level 25 ; (4) FDP has a pro-inflammatory effect by increasing IL-6, TNF-α, and MCP-1 26 , 27 , which can also induce urticaria/erythema 28 .The failed association between D-dimer and BP lesions may suggest that the smaller fibrin degradation products do not contribute obviously to lesion formation 29 . The short half-life of D-dimer and the longer disease duration may lead D-dimer not closely connect to BPDAI 11 .…”

Zinc(II) Induced Neurological Thrombolytic Activities for COVID-19 Thrombus Prevention, Inflammation, Fibrin Degradation, Fibrinolysis of Dissolving Blood Clots and Blood Flow Reperfusion after Thrombolysis

“…Fibrin/fibrinogen degradation products and D-dimer have been positively correlated with injury severity score, and the relationships varied according to trauma severity [23]. Fibrinolysis controls blood coagulation that hypofibrinolysis resulting in impaired clot dissolution is caused to thrombosis in multiple disease states that the mechanism of the anticoagulant effect of fibrin degradation products (FDPs) is unlikely that FDPs exert any target-specific feedback inhibition or amplification of thrombosis [24].…”