Observational studyScandinavian journal of trauma, resuscitation and emergency medicine2024
Trauma induced coagulopathy is limited to only one out of four shock induced endotheliopathy (SHINE) phenotypes among moderate-severely injured trauma patients: an exploratory analysis.
Observational study in Scandinavian journal of trauma, resuscitation and emergency medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Shock Induced Endotheliopathy and High Trauma Mortality-Fight-or-Flight Response Revisited.International journal of molecular sciences · 2026Review
- Real-time prediction of trauma-induced coagulopathy using an inverted transformer (trauma-former): a methodological feasibility and simulation study based on the ADEMP framework.BMC medical research methodology · 2026Article
- Trauma-induced coagulopathy in pediatric traumatic brain injury: incidence, risk factors, and outcomes in a retrospective cohort study.BMC pediatrics · 2026Article
- Artificial intelligence-driven clustering for phenotyping life-threatening prehospital trauma.Scandinavian journal of trauma, resuscitation and emergency medicine · 2026Article
- Early Dysregulation of Angiopoietin-1 and -2 as a Predictor of Mortality in Critically Ill Burn Patients.Journal of burn care & research : official publication of the American Burn Association · 2026Article
- Endothelial Surface Glycocalyx in Vascular Functions and Diseases.Advances in experimental medicine and biology · 2026Review
- Relationship of endothelial activation and stress index on concurrent acute kidney injury in patients with heart failure during intensive care unit: a competing risk model analysis.BMC cardiovascular disorders · 2025Observational
- Inflammatory Cytokines Outperform Endotheliopathy Markers as Early Predictors of Mortality in Trauma.The Journal of surgical research · 2025Article
- Injury induced endotheliopathy: overview, diagnosis, and management.Current opinion in critical care · 2025Review
- Review
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12 authors.
Funding
Abstract
backgroundTrauma induced coagulopathy remains to be an important cause of high transfusion requirements and mortality and shock induced endotheliopathy (SHINE) has been implicated.
methodsEuropean multicenter observational study of adult trauma patients with injury severity score ≥ 16 arriving within 2 h from injury to the trauma centers. Admission blood samples obtained were used for analysis of the SHINE biomarkers (syndecan-1, soluble thrombomodulin, adrenaline) and extensive analysis of coagulation, -and fibrinolytic factors together with collection of clinical data. Hierarchical clustering of the SHINE biomarkers was used to identify the SHINE phenotypes.
resultsThe 313 patients clustered into four SHINE phenotypes. Phenotype 2, having the highest glycocalyx shedding, encompassing 22% of the whole cohort, had severe coagulopathy with lower levels of prothrombin, FV, IX, X, XI and severe hyperfibrinolysis with higher plasmin - alpha 2-antiplasmin (PAP) - and tPA levels and lower alpha2 - antiplasmin levels. This phenotype had significantly higher transfusion requirements and higher mortality (39% vs. 23%, 15% and 14%) but similar injury severity score (ISS) compared to the others phenotypes.
conclusionsHierarchical clustering identified four SHINE phenotype in a cohort of trauma patients. Trauma induced coagulopathy was confined to only one of the SHINE phenotypes, encompassing 22% of the total cohort. This phenotype was characterized by severe hypocoagulability and hyperfibrinolysis, which translated to significantly higher transfusion requirements and higher mortality compared to the other SHINE phenotypes with similar injury severity, warranting further investigation.
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