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TIC prevalence and thrombin levels increase with age. We assayed in vivo and ex vivo thrombin generation in injured patients (n\u2009=\u2009418) to specifically investigate how age impacts thrombin generation in trauma and to address the prognostic ability of thrombin generation. Biomarkers of thrombin generation were elevated in young (&lt;\u200940\u00a0years) and older (\u2265\u200940\u00a0years) trauma patients. In vivo thrombin generation was associated with Injury Severity Score (ISS) and this association was stronger in young than older patients. In vivo thrombin generation decreased faster after trauma in the young than the older patients. Across age groups, in vivo thrombin generation separated patients dying\/surviving within 30\u00a0days at a level comparable to the ISS score (AUC 0.80 vs. 0.82,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&gt;\u20090.76). In vivo and ex vivo thrombin generation also predicted development of thromboembolic events within the first 30\u00a0days after the trauma (AUC 0.70\u20130.84). In conclusion, younger trauma patients mount a stronger and more dynamic in vivo thrombin response than older patients. Across age groups, in vivo thrombin generation has a strong ability to predict death and\/or thromboembolic events 30\u00a0days after injury.\n                  <\/jats:p>","DOI":"10.1038\/s41598-023-28474-7","type":"journal-article","created":{"date-parts":[[2023,1,30]],"date-time":"2023-01-30T08:03:53Z","timestamp":1675065833000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Age-dependent thrombin generation predicts 30-day mortality and symptomatic thromboembolism after multiple trauma"],"prefix":"10.1038","volume":"13","author":[{"given":"Maj","family":"Lesbo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claus V. 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The remaining authors have disclosed that they do not have any conflicts of interest.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"1681"}}