Samuels JM, Moore EE, Coleman JR, et al. - Researchers aimed at determining how obesity (BMI ≥ 30 kg/m² [BMI30]) influences the coagulable state, clot strength and resistance to fibrinolysis postinjury. From their prospective Trauma Activation Protocol database, they assessed 687 trauma activations patients for whom a rapid thrombelastography is obtained within 60 minutes postinjury prior to any transfusions. Of these patients, 161 (23%) had BMI30. The analysis revealed a protective effect of obesity against diminished clot strength and hyperfibrinolysis, and an association of obesity with an increased risk of a fibrinolytic shutdown in severely injured patients. Findings thereby suggest a relative hypercoagulability. Although this study displayed no difference in venous thromboembolic events (VTE), these findings may explain the greater rate of VTEs reported in other studies.