HEMOSTATIC ACTIVATION IN PATIENTS WITH HEAD-INJURY WITH AND WITHOUT SIMULTANEOUS MULTIPLE TRAUMA

In a prospective study including 16 patients with multiple trauma and head injury and 14 patients with isolated head injury we measured plasma levels of prothrombin fragment 1 and 2 (F1+2) and thrombin/antithrombin III complex (TAT) on admission and on days 1, 2, 3, and 7 after the incident. On admission, all patients had values of F1+2 and TAT above the reference range. Admission levels of both F1+2 and TAT were significantly higher compared with levels on the following days. Admission levels of F1+2 was significantly correlated to the Injury Severity Score. TAT was higher in patients with multiple trauma than in patients with isolated head injury and were significantly correlated to the Injury Severity Score on admission and on day 3. Levels of F1+2 were significantly lower on day 1 in four patients with post-traumatic pulmonary dysfunction compared with patients without pulmonary dysfunction. With respect to levels of TAT, no differences were detected between patients with and without pulmonary dysfunction.