Venous Thrombosis After Traumatic Injury

外伤后静脉血栓形成

基本信息

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
项目类别：
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

项目摘要

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，其中超过500,000个VTE事件我们每年。我们的医疗保健系统每年的静脉血栓栓塞费用超过80亿美元仅在美国，每年就有100,000多人死亡。静脉血栓主义在经历创伤的患者。尽管在创伤患者中施用了化学预防住院，约有5％的患者在出院前仍会出现症状性VTE，更令人震惊的是40 -60％发生症状性VTE的患者，出院后这样做。对创伤的准确评估基于伤害的凝血病仍然取决于无法解决的基本科学知识国家卫生研究院（NIH）定义“实验室监测的作用……帮助更好地定义那些有出血和血栓形成的风险。” 血栓栓塞，一种评估血浆凝血因子活动的综合方法，血小板在创伤前患者特征（性，BMI，吸烟）的背景下，反应性和内皮功能等等）和“实时”血液研究需要在创伤时”。获得综合实验室和临床数据在单个研究者的实验室或现场，来自潜水员创伤的患者人群不容易可行。这长期目标是制定新颖的预测性，诊断和治疗策略，以识别“处于危险”的个人在创伤后不久进行VTE或出血。我们的中心假设是临床意义的血栓形成需要 Netosis，凝血酶产生，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患者。调查人员来自多个与健康相关的专业人员，并利用经验以及来自不同但相关学科的知识。我们的合作也鼓励并培养科学询问将创建和传播新知识和应用的科学专业知识。最后，我们达到高潮的团队科学方法将提供最高质量的护理和改善创伤健康结果。