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.

项目概要静脉血栓栓塞 (VTE) 仍然是一个主要的健康问题，全球发生了超过 500,000 起 VTE 事件美国每年因静脉血栓栓塞给我们的医疗保健系统造成超过 80 亿美元的损失。仅在美国每年就有超过 100,000 人死亡，静脉血栓栓塞在以下国家尤其严重。尽管在治疗期间对遭受创伤的患者进行了化学预防。住院期间，约 5% 的患者在出院前仍出现有症状的 VTE，更令人担忧的是，40 - 60% 出现症状性 VTE 的患者是在出院后出现的准确评估创伤性 - 基于损伤的凝血病仍然依赖于解决所需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形成风险的人。”了解创伤引起的静脉血栓的病因。” 血栓栓塞，一种评估血浆凝血因子活性、血小板的综合方法创伤前患者特征（性别、BMI、吸烟）背景下的反应性和内皮功能等），并且需要在创伤时进行“实时”血液研究”。从不同的创伤患者群体中获取信息在单个研究者的实验室或地点并不容易实现。长期目标是开发新的预测、诊断和治疗策略来识别“高危”个体对于 VTE 或创伤后不久的出血，我们的中心假设是临床上显着的血栓形成需要。 NETosis、凝血酶生成、内皮损伤和冯·维勒布兰德因子的综合失调我们的合作体现了改善血小板功能障碍的护理质量所需的所有要素。调查人员来自多个健康相关专业，这利用了经验。我们的合作还鼓励和促进科学发展。科学专业知识的探究将创造和传播新的知识和应用。我们最终达到的团队科学方法预计将提供最高质量的护理和改善创伤健康结果。