{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T16:54:53Z","timestamp":1790960093910,"version":"4.1.0"},"reference-count":33,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T00:00:00Z","timestamp":1774656000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T00:00:00Z","timestamp":1774656000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The precise thresholds at which admission fibrinogen predicts mortality and organ dysfunction in trauma patients are unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design and Methods<\/jats:title>\n                    <jats:p>Retrospective study at a single trauma center. Inclusion criteria: 18\u201389\u2009years, traumatic mechanism, transported from scene, and fibrinogen obtained within 30\u2010min of arrival. Admission fibrinogen: &lt;150, 150\u2013199, 200\u2013249, and \u2265250\u2009mg\/dL. Primary outcome: 28\u2010day mortality. Multivariable logistic regression analysis described the risk of 28\u2010day mortality by fibrinogen levels. Secondary outcomes: 24\u2010h mortality, acute kidney injury (AKI) and acute respiratory distress syndrome (ARDS). The optimal threshold of admission fibrinogen associated with AKI and ARDS was determined. Results reported as odds ratio (OR) with 95% confidence interval (CI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Two thousand five hundred and five patients included. Admission fibrinogen: 94 (3.8%) &lt;150\u2009mg\/dL, 225 (9.0%) 150\u2013199\u2009mg\/dL, 533 (21.3%) 200\u2013249\u2009mg\/dL, and 1653 (66.0%) \u2265250\u2009mg\/dL. Twenty\u2010eight\u2010day mortality occurred in 239\/2505 (9.5%), and 114\/2505 (4.6%) died within 24\u2009h. Fibrinogen &lt;150\u2009mg\/dL (OR: 11.86, 95% CI: 5.80\u201324.26;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u2009.001) and fibrinogen 150\u2013199\u2009mg\/dL (OR: 2.20, 95% CI 1.22\u20133.96;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.009) were associated with 28\u2010day mortality. Admission fibrinogen &lt;150 and 150\u2013200\u2009mg\/dL were also associated with 24\u2009h mortality. The optimal cutoff of fibrinogen and AKI was &lt;238\u2009mg\/dL, which predicted AKI (OR: 2.45, 95% CI: 1.4\u20134.4). The optimal cutoff of fibrinogen and ARDS was &lt;235\u2009mg\/dL, and predicted ARDS (OR: 1.9, 95% CI: 1.01\u20133.55).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Admission hypofibrinogenemia &lt;200\u2009mg\/dL is associated with 28\u2010day and 24\u2009h mortality in trauma patients. Admission fibrinogen is also a marker for post\u2010traumatic AKI and ARDS.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/trf.70200","type":"journal-article","created":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T08:46:07Z","timestamp":1774687567000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Elevating the standards of hypofibrinogenemia in trauma: Higher thresholds of admission fibrinogen predict mortality and organ dysfunction"],"prefix":"10.1111","volume":"66","author":[{"given":"Justin","family":"Richards","sequence":"first","affiliation":[{"name":"Department of Anesthesiology University of Maryland School of Medicine  Baltimore Maryland USA"},{"name":"Program in Trauma, R Adams Cowley Shock Trauma Center University of Maryland School of Medicine  Baltimore Maryland 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Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosemary","family":"Kozar","sequence":"additional","affiliation":[{"name":"Program in Trauma, R Adams Cowley Shock Trauma Center University of Maryland School of Medicine  Baltimore Maryland USA"},{"name":"Department of Surgery University of Maryland School of Medicine  Baltimore Maryland 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