Background
Recent studies suggest there are gender-specific differences in injury response that
may be related to coagulation. The objective of this study was to test the hypothesis
that rapid thrombelastography (rTEG) coagulation profiles differ by gender.
Methods
Adult trauma patients were prospectively followed at 3 level 1 trauma centers over
a 14-month period. rTEG was obtained upon arrival and serially at several time points
during the hospital stay. Female patients were stratified into premenopausal (≤50 years)
and postmenopausal (>50 years) age groups with age-matched male cohorts. Values were
analyzed using a repeated-measures multilevel linear model to evaluate the effect
of gender on coagulation.
Results
A total of 795 patients had serial rTEG data (24% female and 76% male). Compared with
age-matched males, premenopausal females were more hypercoagulable by rTEG on admission
(P < .001) and for the first 12 hours after arrival. Gender was an effect modifier for
alpha angle (P = .02) and maximum amplitude (P = .04). Controlling for Injury Severity Score and mechanism of injury, age-matched
males had a >4-fold increased risk of hypercoagulable complications than premenopausal
females (odds ratio, 4.7; P = .038).
Conclusion
This prospective, multicenter study demonstrates that premenopausal females are relatively
hypercoagulable compared with age-matched males early after injury. However, this
did not translate into higher thromboembolic complications.
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Article info
Publication history
Published online: June 19, 2014
Accepted:
April 14,
2014
Footnotes
Supported, in part, by a research grant from Haemonetics Corporation (Braintree, MA), the makers of TEG.
Identification
Copyright
© 2014 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
