The procoagulant molecule PAI-1 is associated with injury severity and shock in patients with and without traumatic brain injury.

Background Traumatic injury is associated with an increased risk of coagulopathy and venous thrombosis. PAI-1 is a procoagulant molecule that inhibits tPA/uPA, thrombomodulin, and activated protein C. We hypothesized that elevated PAI-1 levels would be associated with increased Injury Severity Score (ISS) in injured patients with and without traumatic brain injury and that PAI-1 levels would vary with injury type. Methods We retrospectively analyzed demographic, ISS, and hemodynamic data from a prospectively collected database. Patients with traumatic injury requiring Intensive Care Unit (ICU) admission (n=268) were classified as polytrauma, isolated body, or isolated head based on Abbreviated Injury Severity score. Admission PAI-1 levels were quantified using a Luminex analyte platform. Univariate tests for association informed the construction of a multivariate model of the relationship between PAI-1 and ISS. Results PAI-1 positively associated with ISS (p <.0001 and was highest in patients with iss>35 (p<.0001. pai-1 was significantly different between polytrauma isolated body and head patients on univariate analysis age hypotension alcohol intoxication were all positively associated with level. admission international normalized ratio not level after adjusting for sex higher levels iss conclusions elevated at is injury severity score. this association more pronounced in hypotension. these findings suggest that may reflect the burden of endothelial damage platelet activation injury. evidence iii prognostic correspondence: mary condron telephone: fax: division trauma critical care acute surgery oregon health science university sw sam jackson park rd l611 portland or conflict interest statement: none presented annual meeting western february whistler british columbia. disclosures funding: project described supported part by award number from national heart lung blood institute. publication clinical translational research institute grant center advancing sciences institutes lippincott williams wilkins inc.>

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