Hypoperfusion appears to be a primary driver of trauma coagulopathy. Trauma induced coagulopathy is only evident in the presence of tissue hypoperfusion

Coagulopathy is associated with combination of tissue hypoperfusion and tissue injury in a mice model

Coagulopathy developed in rats subjected to haemorrhagic shock and tissue perfusion.

Patients with severe tissue injury but no physiologic derangement rarely present with a coagulopathy. Tissue trauma is, therefore, an initiator of coagulation, but in isolation is rarely responsible for clinical coagulopathy.