Trial reportShock (Augusta, Ga.)2014
Postinjury hyperfibrinogenemia compromises efficacy of heparin-based venous thromboembolism prophylaxis.
Trial report in Shock (Augusta, Ga.), 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 47 citations in OpenAlex.
- ISTH DIC subcommittee communication on anticoagulation in COVID-19.Journal of thrombosis and haemostasis : JTH · 2020Guideline
- Association Between Preoperative Calcium Levels and the Occurrence of Postoperative PE in Trauma Patients: A Retrospective Multicenter Cohort Study.World journal of surgery · 2026Article
- Preclinical safety and bleeding evaluation in swine for a small interfering RNA-lipid nanoparticle that prevents excess fibrinogen synthesis.Journal of thrombosis and haemostasis : JTH · 2026Article
- Racing toward a common biology of venous thromboembolism prophylaxis: the small interfering RNA fibrinogen knockdown strategy.Journal of thrombosis and haemostasis : JTH · 2026Article
- Perioperative Hyper-coagulation and Thrombosis: Cost Analysis After Congenital Heart Surgery.Pediatric cardiology · 2025Article
- Antithrombin III Levels and Outcomes Among Patients With Trauma.JAMA network open · 2024Article
- Article
- Role of Fibrinolysis in the Management of Patients with COVID-19 and Thromboembolic Complications: A Review.Journal of cardiovascular development and disease · 2022Review
- Anticoagulation Monitoring with Activated Partial ThromboPlastin Time and Anti-Xa Activity in Intensive Care Unit Patients: Interest of Thrombin Generation Assay.International journal of molecular sciences · 2022Observational
- Observational
- Heparin - Messias or Verschlimmbesserung?Journal of thrombosis and haemostasis : JTH · 2021Review
- High-value laboratory testing for hospitalized COVID-19 patients: a review.Future virology · 2021Review
- Chinese expert consensus on diagnosis and treatment of trauma-induced hypercoagulopathy.Military Medical Research · 2021Article
- Complex and prolonged hypercoagulability in coronavirus disease 2019 intensive care unit patients: A thromboelastographic study.Australian critical care : official journal of the Confederation of Australian Critical Care Nurses · 2021Article
- Intensity of anticoagulation and survival in patients hospitalized with COVID-19 pneumonia.Thrombosis research · 2020Article
- Emerging patterns of hypercoagulability associated with critical COVID-19: A review.Trends in anaesthesia & critical care · 2020Review
- A critical review of the pathophysiology of thrombotic complications and clinical practice recommendations for thromboprophylaxis in pregnant patients with COVID-19.Acta obstetricia et gynecologica Scandinavica · 2020Review
- Article
- ISTH interim guidance on recognition and management of coagulopathy in COVID-19: A comment.Journal of thrombosis and haemostasis : JTH · 2020Article
- Targeting resuscitation to normalization of coagulating status: Hyper and hypocoagulability after severe injury are both associated with increased mortality.American journal of surgery · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
backgroundVenous thromboembolism (VTE) prophylaxis remains debated following trauma, and recommendations have not been established. Although hyperfibrinogenemia is a marker of proinflammatory states, it also contributes to thrombus formation. Postinjury hyperfibrinogenemia is common, but the effect of hyperfibrinogenemia on VTE prophylaxis has not been fully elucidated. Therefore, we hypothesized that heparin is less effective for VTE prophylaxis following severe injury due to hyperfibrinogenemia.
methodsIn vitro studies evaluated thromboelastography (TEG) parameters in 10 healthy volunteers after the addition of fibrinogen concentrate and heparin. Data from a recent randomized controlled trial, conducted at an academic level I trauma center surgical intensive care unit, were reviewed. Critically injured patients were randomized to standard VTE prophylaxis (5,000 U low-molecular-weight heparin daily) or TEG-guided prophylaxis (up to 10,000 U low-molecular-weight heparin daily) and were followed up for 5 days. Analysis was performed to evaluate the relationship between fibrinogen levels, measures of anticoagulation, and TEG parameters.
resultsIn vitro studies revealed increased fibrinogen reversed the effects of heparin as measured by TEG. Fifty patients were enrolled in the clinical study with 25 in each arm. Thromboelastography parameters, fibrinogen, platelet count, and anti-Xa levels did not differ between groups despite treatment provided. Fibrinogen levels increased over the 5-day study period (597 ± 24.0 to 689.3 ± 25.0), as well as clot strength (9.8 ± 0.4 to 14.5 ± 0.6), which had a significant correlation coefficient (P < 0.01). Moreover, there was a moderate inverse correlation between fibrinogen level and the effect of heparin (RF), which was significant on study days 1 and 3, implicating hyperfibrinogenemia in heparin resistance.
conclusionsHypercoagulability and heparin resistance are common following trauma. The preclinical and clinical relationships between fibrinogen levels and hypercoagulability implicate hyperfibrinogenemia as a potential factor in heparin resistance.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.