Predictors of Venous Thromboembolism: A Multicenter Prospective Cohort Study

静脉血栓栓塞的预测因素：多中心前瞻性队列研究

基本信息

批准号：
10172926
负责人：
MYUNG SOO PARK
金额：
$ 70.35万
依托单位：
MAYO CLINIC ROCHESTER
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-05 至 2023-05-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10172926
关键词：
Acute Address Age Assessment tool Biological Markers Blood Body mass index Candidate Disease Gene Categories Cessation of life Characteristics Chemoprophylaxis Clinical Clinical Data Coagulation Process Cohort Studies Complication Data Deep Vein Thrombosis Development Diagnosis Disease Event Generations Genotype Health Healthcare Systems Hemorrhage Hospitalization Incidence Individual Injury Joints Kinetics Knowledge Laboratories Leg Medical Monitor Operative Surgical Procedures Patients Persons Phenotype Plasma Population Population Attributable Risks Predictive Value Preventive measure Prophylactic treatment Prospective cohort study Prothrombin Pulmonary Embolism Risk Risk Assessment Risk Factors Role Screening procedure Standardization Surgeon Thrombin Thrombophilia Thrombosis Time Trauma Trauma patient United States United States Centers for Medicare and Medicaid Services United States National Institutes of Health Validation base case control clinical application clinical practice clinical risk cohort cost factor V Leiden genome wide association study high risk improved individual patient injured novel novel diagnostics prevent prospective risk prediction risk stratification tool trauma centers venous thromboembolism

项目摘要

Project Summary / Abstract Project Summary Venous thromboembolism (VTE) manifests as deep vein thrombosis (DVT) of the leg and its complication, pulmonary embolism (PE). VTE is a major health problem with over 400,000 VTE events in the US annually. VTE costs more than $8 billion per year to our health care system and causes more than 100,000 deaths per year in the US alone. Despite administration of chemoprophylaxis to trauma patients during hospitalization, about 5% of patients still develop symptomatic VTE prior to discharge and more alarmingly, about 40-60% of patients develop symptomatic VTE after discharge. Hence, we need a personalized and individualized VTE risk score for acutely injured patients and to address the NIH initiative of defining the “role of laboratory monitoring… to help better define those at risk of bleeding and thrombosis.” Our specific aims will address current gaps in knowledge by: (Aim 1) validation of a VTE risk prediction tool for the individual with acute trauma using clinical data, novel plasma biomarkers, and (Aim 2) to assess if addition of genotype data (i.e., F5 rs6025 [Factor V Leiden], F2 rs1799963 [Prothrombin G20210A], and ABO rs8176719 [non-O blood type]) improve the accuracy of the prediction tool. Successful completion of our study aims will provide a validated, generalizable, clinically-applicable risk assessment tool for stratifying risk of VTE in the individual trauma patient. This risk tool, which incorporates easily obtainable clinical risk factors, as well as the individual patient's prothrombotic phenotype and genotype, will more accurately predict the occurrence of symptomatic VTE after injury.

项目摘要 /摘要项目摘要静脉血栓栓塞（VTE）表现为腿的深静脉血栓形成（DVT）及其并发症，肺栓塞（PE）。 VTE是美国年度超过40万VTE活动的主要健康问题。 VTE每年对我们的医疗保健系统的费用超过80亿美元，每年造成100,000多人死亡仅在美国。尽管在住院期间将化学预防症用于创伤患者，但大约5％的患者在出院前仍会出现症状性VTE，更令人震惊，约有40-60％出院后患者会出现症状性VTE。因此，我们需要一个个性化和个性化的VTE 急性伤害患者的风险评分，并解决NIH的倡议，以定义“实验室的作用监视…有助于更好地定义有出血和血栓形成风险的人。”我们的具体目标将解决通过：（目标1）验证急性个人的VTE风险预测工具的当前差距使用临床数据，新型血浆生物标志物和（目标2）的创伤，以评估添加基因型数据（即 F5 RS6025 [Factor V Leiden]，F2 RS1799963 [凝血酶原G20210A]和ABO RS8176719 [non-O血型]）提高预测工具的准确性。成功完成我们的研究目标将提供经过验证的，可概括的，可临床上适用的风险评估工具，用于分层单个创伤中VTE的风险病人。该风险工具，结合了易于获得的临床风险因素以及个人患者的促血栓性表型和基因型将更准确地预测症状的发生受伤后VTE。