Incidence of ROTEM®-defined coagulopathy at hospital arrival
among polytrauma patients receiving fibrinogen concentrate in
prehospital setting: a prospective observational study

J 2026

Incidence of ROTEM®-defined coagulopathy at hospital arrival among polytrauma patients receiving fibrinogen concentrate in prehospital setting: a prospective observational study

VRBICA, Kamil; Filip KELLER; Jan ŠTINGL; Kateřina VANÍČKOVÁ; Radka ŠTĚPÁNOVÁ et al.

Základní údaje

Originální název

Incidence of ROTEM®-defined coagulopathy at hospital arrival among polytrauma patients receiving fibrinogen concentrate in prehospital setting: a prospective observational study

Autoři

VRBICA, Kamil; Filip KELLER; Jan ŠTINGL; Kateřina VANÍČKOVÁ; Radka ŠTĚPÁNOVÁ; Martin DOLEČEK; Ondřej HRDÝ a Roman GÁL

Vydání

European Journal of Trauma and Emergency Surgery, HEIDELBERG, Springer-Verlag GmbH Germany, 2026, 1863-9933

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Obor

30221 Critical care medicine and Emergency medicine

Stát vydavatele

Německo

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 2.200 v roce 2024

Označené pro přenos do RIV

Ano

Organizační jednotka

Lékařská fakulta

Klíčová slova anglicky

Fibrinogen; Blood coagulation tests; Trauma; Platelets; Point of care testing

Štítky

14110233, 14110516, rivok

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 12. 5. 2026 10:31, Mgr. Tereza Miškechová

Anotace

V originále

Purpose Trauma-induced coagulopathy affects approximately one-quarter of polytrauma patients and is associated with increased mortality. Given the central role of fibrinogen and its early depletion after injury, supplementation is recommended after hospital admission in the presence of hypofibrinogenaemia or suspected major haemorrhage. As coagulopathy develops within minutes of trauma, prehospital fibrinogen administration may help mitigate its progression before hospital arrival. This study evaluated the incidence of coagulopathy at hospital admission, assessed using ROTEM®, among polytrauma patients receiving fibrinogen concentrate in the prehospital setting. Methods In this single-centre, prospective observational study, adult patients with polytrauma (Injury Severity Score ≥ 16) were enrolled after prehospital administration of fibrinogen concentrate. The primary outcome was the presence of coagulopathy at hospital arrival, defined according to predefined ROTEM® Delta thresholds (FIBTEM MCF ≤ 8 mm and/or EXTEM CT ≥ 80 s and/or EXTEM MCF ≤ 49 mm). The secondary outcomes were laboratory coagulation status, 28-day all-cause mortality, and thromboembolic complications. Results Thirty patients were enrolled, of whom 28 were included in the final analysis. Twenty-seven patients received 4 g of fibrinogen concentrate and one received 2 g due to short transport time. ROTEM®-defined coagulopathy was identified in two patients (7.1%), both based on EXTEM abnormalities; no patient had reduced FIBTEM MCF. Five patients (17.9%) died within 28 days and two patients (7.1%) experienced thromboembolic complications. Conclusions Our findings describe a low incidence of ROTEM®-defined coagulopathy at hospital arrival in polytrauma patients who received prehospital fibrinogen concentrate. Adequately powered randomized controlled trials are required to determine whether prehospital fibrinogen administration reduces coagulopathy and improves clinically relevant outcomes.

Návaznosti

LM2023049, projekt VaV

Název: Český národní uzel Evropské sítě infrastruktur klinického výzkumu

Investor: Ministerstvo školství, mládeže a tělovýchovy ČR, CZECRIN - Czech National Node to the European Clinical Research Infrastructure Network

MUNI/A/1801/2025, interní kód MU

Název: Role fibrinogenu u pacientů s polytraumatem II

Investor: Masarykova univerzita, Role fibrinogenu u pacientů s polytraumatem II

Citovat

VRBICA, Kamil; Filip KELLER; Jan ŠTINGL; Kateřina VANÍČKOVÁ; Radka ŠTĚPÁNOVÁ; Martin DOLEČEK; Ondřej HRDÝ a Roman GÁL. Incidence of ROTEM®-defined coagulopathy at hospital arrival among polytrauma patients receiving fibrinogen concentrate in prehospital setting: a prospective observational study. European Journal of Trauma and Emergency Surgery. HEIDELBERG: Springer-Verlag GmbH Germany, 2026, roč. 52, č. 1, s. 1-7. ISSN 1863-9933. Dostupné z: https://doi.org/10.1007/s00068-026-03183-8.

@article{2571799,
   author = {Vrbica, Kamil and Keller, Filip and Štingl, Jan and Vaníčková, Kateřina and Štěpánová, Radka and Doleček, Martin and Hrdý, Ondřej and Gál, Roman},
   article_location = {HEIDELBERG},
   article_number = {1},
   doi = {https://doi.org/10.1007/s00068-026-03183-8},
   keywords = {Fibrinogen; Blood coagulation tests; Trauma; Platelets; Point of care testing},
   language = {eng},
   issn = {1863-9933},
   journal = {European Journal of Trauma and Emergency Surgery},
   title = {Incidence of ROTEM®-defined coagulopathy at hospital arrival among polytrauma patients receiving fibrinogen concentrate in prehospital setting: a prospective observational study},
   url = {https://link.springer.com/article/10.1007/s00068-026-03183-8},
   volume = {52},
   year = {2026}
}

TY  - JOUR
ID  - 2571799
AU  - Vrbica, Kamil - Keller, Filip - Štingl, Jan - Vaníčková, Kateřina - Štěpánová, Radka - Doleček, Martin - Hrdý, Ondřej - Gál, Roman
PY  - 2026
TI  - Incidence of ROTEM®-defined coagulopathy at hospital arrival among polytrauma patients receiving fibrinogen concentrate in prehospital setting: a prospective observational study
JF  - European Journal of Trauma and Emergency Surgery
VL  - 52
IS  - 1
SP  - 1-7
EP  - 1-7
PB  - Springer-Verlag GmbH Germany
SN  - 18639933
KW  - Fibrinogen
KW  - Blood coagulation tests
KW  - Trauma
KW  - Platelets
KW  - Point of care testing
UR  - https://link.springer.com/article/10.1007/s00068-026-03183-8
N2  - Purpose Trauma-induced coagulopathy affects approximately one-quarter of polytrauma patients and is associated with increased mortality. Given the central role of fibrinogen and its early depletion after injury, supplementation is recommended after hospital admission in the presence of hypofibrinogenaemia or suspected major haemorrhage. As coagulopathy develops within minutes of trauma, prehospital fibrinogen administration may help mitigate its progression before hospital arrival. This study evaluated the incidence of coagulopathy at hospital admission, assessed using ROTEM®, among polytrauma patients receiving fibrinogen concentrate in the prehospital setting. Methods In this single-centre, prospective observational study, adult patients with polytrauma (Injury Severity Score ≥ 16) were enrolled after prehospital administration of fibrinogen concentrate. The primary outcome was the presence of coagulopathy at hospital arrival, defined according to predefined ROTEM® Delta thresholds (FIBTEM MCF ≤ 8 mm and/or EXTEM CT ≥ 80 s and/or EXTEM MCF ≤ 49 mm). The secondary outcomes were laboratory coagulation status, 28-day all-cause mortality, and thromboembolic complications. Results Thirty patients were enrolled, of whom 28 were included in the final analysis. Twenty-seven patients received 4 g of fibrinogen concentrate and one received 2 g due to short transport time. ROTEM®-defined coagulopathy was identified in two patients (7.1%), both based on EXTEM abnormalities; no patient had reduced FIBTEM MCF. Five patients (17.9%) died within 28 days and two patients (7.1%) experienced thromboembolic complications. Conclusions Our findings describe a low incidence of ROTEM®-defined coagulopathy at hospital arrival in polytrauma patients who received prehospital fibrinogen concentrate. Adequately powered randomized controlled trials are required to determine whether prehospital fibrinogen administration reduces coagulopathy and improves clinically relevant outcomes.
ER  -

VRBICA, Kamil; Filip KELLER; Jan ŠTINGL; Kateřina VANÍČKOVÁ; Radka ŠTĚPÁNOVÁ; Martin DOLEČEK; Ondřej HRDÝ a Roman GÁL. Incidence of ROTEM®-defined coagulopathy at hospital arrival among polytrauma patients receiving fibrinogen concentrate in prehospital setting: a prospective observational study. \textit{European Journal of Trauma and Emergency Surgery}. HEIDELBERG: Springer-Verlag GmbH Germany, 2026, roč.~52, č.~1, s.~1-7. ISSN~1863-9933. Dostupné z: https://doi.org/10.1007/s00068-026-03183-8.

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