Venous Thrombosis After Traumatic Injury

外伤后静脉血栓形成

• 批准号: 10655727
• 负责人: Matthew Auton
• 金额: $ 68.5万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-15 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10655727
• 关键词: ADAMTS; Acceleration; Address; Adhesives; Artificial Intelligence; Binding; Biological Assay; Biological Markers; Blood; Blood Coagulation Disorders; Blood Coagulation Factor; Blood Platelets; Blood Vessels; Blood specimen; Body mass index; Calibration; Categories; Cessation of life; Characteristics; Chemoprophylaxis; Clinical; Clinical Data; Coagulation Process; Collaborations; Complex; Complication; Consumption; Data; Deep Vein Thrombosis; Deoxyribonuclease I; Deposition; Development; Discipline; Elements; Endothelial Cells; Endothelium; Etiology; Event; Factor VIII-Related Antigen; Fibrin; Fibrinogen; Fostering; Foundations; Functional disorder; Future; Generations; Goals; Health; Healthcare Systems; Hemorrhage; Hemostatic function; Hospitalization; Hyperactivity; Incidence; Individual; Injury; Intervention; Joints; Kinetics; Knowledge; Laboratories; Ligands; Machine Learning; Modeling; Molecular Conformation; Monitor; Multiple Trauma; Mus; Outcome; Pathogenesis; Patients; Plasma; Play; Process; Protein-arginine deiminase; Pulmonary Embolism; Quality of Care; RNA; Recommendation; Research Personnel; Risk; Risk Assessment; Risk Factors; Role; Sampling; Science; Scientific Inquiry; Sensitivity and Specificity; Site; Smoking; Surgeon; Testing; Therapeutic; Thrombin; Thrombophilia; Thrombosis; Time; Tissue Sample; Trauma; Trauma patient; Traumatic injury; United States; United States National Institutes of Health; Venous Thrombosis; aptamer; arm; cleavage factor; clinically significant; cost; diagnostic strategy; diverse data; experience; extracellular; high risk; improved; improved outcome; injured; insight; mouse model; neutrophil; new therapeutic target; novel; patient population; predictive marker; prevent; sex; statistics; syndecan; therapeutic target; tissue injury; treatment strategy; venous thromboembolism; von Willebrand Factor

PROJECT SUMMARY Venous thromboembolism (VTE) continues to be a major health problem with over 500,000 VTE events in the US annually. Venous thromboembolism 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. Venous thromboembolism is particularly problematic in patients who experience trauma. Despite administration of chemoprophylaxis to trauma patients during hospitalization, about 5% of patients still develop symptomatic VTE prior to discharge, and, more alarmingly, 40 - 60% of patients who develop symptomatic VTE, do so after discharge. An accurate assessment of traumatic- injury based coagulopathies remains dependent on unavailable basic scientific knowledge needed to address the National Institutes of Health (NIH) initiative of defining the “role of laboratory monitoring…to help better define those at risk of bleeding and thrombosis.” To understand the etiologies of trauma-induced venous thromboembolism, a comprehensive approach that assesses plasma coagulation factor activities, platelet reactivity, and endothelial function within the context of pre-trauma patient characteristics (sex, BMI, smoking etc.) and “real-time” blood studies at the time of trauma is required”. Obtaining integrated lab and clinical data from a diverse trauma patient population is not readily feasible in a single investigator’s laboratory or site. The long-term goal is to develop novel predictive, diagnostic and treatment strategies that identify “at risk” individuals for VTE or bleeding soon after trauma. Our Central Hypothesis is that clinically significant thrombosis requires the integrated dysregulation of NETosis, thrombin generation, endothelial injury, and von Willebrand factor- platelet dysfunction. Our collaboration embodies all of the elements needed to improve the quality of care of trauma patients. The investigators are from multiple health-related professions and this leverages experiences and knowledge from different, but related disciplines. Our collaboration also encourages and fosters scientific inquiry with the scientific expertise that will create and disseminate new knowledge and applications. Finally, the team science approach that we have culminated is expected to provide for the highest quality of care and improvement of trauma health outcomes.

项目摘要 静脉血栓栓塞（VTE）仍然是一个主要的健康问题，在美国有超过500，000例VTE事件。 美国每年静脉血栓栓塞每年给我们的卫生保健系统造成的费用超过80亿美元， 仅在美国每年就有超过10万人死亡。静脉血栓栓塞是特别成问题的， 经历创伤的患者。尽管对创伤患者进行了化学预防， 在住院期间，约5%的患者在出院前仍会出现症状性VTE，更令人担忧的是，40 - 60%出现症状性VTE的患者在出院后出现症状。准确评估创伤- 基于损伤的凝血病仍然依赖于不可用的基础科学知识， 美国国立卫生研究院（NIH）倡议定义“实验室监测的作用......以帮助更好地定义 那些有出血和血栓风险的人。”了解创伤性静脉曲张的病因 血栓栓塞，一种评估血浆凝血因子活性、血小板 反应性和内皮功能在创伤前患者特征（性别、BMI、吸烟）的背景下 等等）。需要在创伤时进行“实时”血液研究”。获得综合实验室和临床数据 从不同的创伤患者群体中进行的研究在单个研究者的实验室或地点是不容易可行的。的 长期目标是开发新的预测、诊断和治疗策略，以识别“高危”个体 静脉血栓栓塞或外伤后出血我们的中心假设是，临床上显著的血栓形成需要 NETosis、凝血酶生成、内皮损伤和血管性血友病因子的综合失调- 血小板功能障碍我们的合作体现了提高护理质量所需的所有要素， 创伤病人调查人员来自多个与健康相关的专业， 和不同但相关学科的知识。我们的合作还鼓励和促进科学 通过科学专门知识进行调查，创造和传播新知识和应用。最后 团队科学的方法，我们已经达到高潮，预计将提供最高质量的护理， 改善创伤健康结果。