Venous Thrombosis After Traumatic Injury

项目总结 静脉血栓栓塞症(VTE)仍然是一个主要的健康问题，在美国有500,000多起VTE事件 我们每年一次。静脉血栓栓塞症每年给我们的医疗保健系统造成的损失超过80亿美元，并导致 仅在美国，每年就有超过10万人死亡。静脉血栓栓塞症在以下方面尤其严重 经历过创伤的病人。尽管对创伤患者进行了化学预防 住院期间，约5%的患者在出院前仍有症状性静脉血栓形成，更令人担忧的是，40%的患者在出院前仍有症状 -60%出现症状性VTE的患者在出院后出现这种情况。对创伤的准确评估- 基于损伤的凝固性疾病仍然依赖于无法获得的基本科学知识来解决 美国国立卫生研究院提出的定义“实验室监测…的作用”的倡议帮助更好地定义 那些有出血和血栓形成风险的人。了解外伤性静脉血栓形成的病因 血栓栓塞症：一种评估血浆凝血因子活性和血小板的综合方法 创伤前患者特征(性别、体重指数、吸烟)的反应性和内皮功能 等)并且需要在创伤时进行“实时”血液检测“。获取完整的实验室和临床数据 从一个不同的创伤患者群体中分离出来，在单个研究人员的实验室或现场是不容易实现的。这个 长期目标是开发新的预测性、诊断性和治疗策略，以识别“高危”个体 静脉血栓或创伤后不久出血。我们的中心假设是临床上显著的血栓形成需要 网织红细胞增多症、凝血酶生成、内皮损伤和von Willebrand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职业，这利用了他们的经验 以及来自不同但相关学科的知识。我们的合作还鼓励和促进科学 具有创造和传播新知识和新应用的科学专长的研究。最后， 我们已经达到顶峰的团队科学方法有望提供最高质量的护理和 改善创伤健康结局。

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.