Predictors of Hagemo et al for Hypofibrinogenemia in an Adult Trauma Patient

 

The authors found that an initial fibrinogen < 229 mg/dL (< 2.29 g/L) was associated with increased 28-day mortality.

 

Predictors of low fibrinogen:

(1) low age (with inclusion criteria an age >= 18 years of age)

(2) male gender

(3) delay in arrival to the trauma center

(4) low base excess (= metabolic acidosis) with a base excess < -5 mmol/L defined as hypoperfused

(5) high injury severity score (ISS)

 

A patient with a low fibrinogen:

(1) should probably be screened for evidence of DIC

(2) may benefit from fibrinogen replacement (cryoprecipitate) if bleeding