Background: After patients suffer from traumatic injuries, the clotting mechanism in the blood is accelerated, but the mechanism involved in this acceleration is not clearly understood. The goal of this proposal titled,"""""""" Microvesicle production after acute trauma and its clinical impact on venothromboembolism,"""""""" is to investigate the role of sub-cellular particles that are released by injured tissue. It is believed that these particles, called microvesicles, are released from tissue such as white blood cells and platelets during infection, injury and cell death. On their surface, the microvesicles carry a cargo of clotting enzymes and cell membrane components thought to be important in clot generation. By gaining a better understanding of their role in clotting after injury, we can begin to look for ways to identify patients who may have high amount of microvesicles in their blood and to see if they are more prone to clotting such as deep leg clots (also known as deep vein thrombosis) or clots lodged in the lung (also known as pulmonary embolism), collectively known as venous thromboembolism. In the United States alone, there are over 900,000 cases per year of deep vein thrombosis and pulmonary embolism in hospitalized patients. Trauma patients are especially at high risk of developing these complications. The immediate goal of the proposed research is to be able to identify those trauma patients, based on their physical characteristics (such as age, sex, injury severity) and their blood clotting physiology (such as type and number of microvesicles found in the blood after trauma). Proposed Research: It has two components. The first component will be an extensive review of the medical records of trauma patients who suffered from deep vein thrombosis and pulmonary embolism in Olmsted County, Minnesota (1996-2005). We will study their physical characteristics and assess which are important risk factors for clotting. The second research component is an observational study involving the measurement of microvesicle clotting potential in trauma patients who develop venous thromboembolism. This study will create several opportunities for the applicant. A risk/assessment model will be generated from the proposed research. Ultimately, this information will allow us to better target aggressive therapy early to those assessed to be at high-risk of the morbid hospital complication of venous thromboembolism. Applicant: The applicant is a Trauma/Critical Care Surgeon at the Mayo Clinic in Rochester MN, who is applying for a Mentored Career Development Award. This award entails a research and a career development plan;the receipt of this award will give the applicant protected time to focus on her research objectives and in obtaining a Masters in Biomedical Science Degree. The long-term research goal of the applicant is for her to be an independent physician-scientist with the tools and skills needed to continue her clinical studies that will have a positive impact on the outcome of trauma patients.
In the United States, there are over 900,000 cases per year of an abnormal clotting that occurs in the legs and lung. Almost a third of the patients with this clotting abnormality die as a result of this. More research needs to be done to better diagnose and prevent this complication.
|Park, Myung S; Spears, Grant M; Bailey, Kent R et al. (2017) Thrombin generation profiles as predictors of symptomatic venous thromboembolism after trauma: A prospective cohort study. J Trauma Acute Care Surg 83:381-387|
|Park, Myung S; Perkins, Sarah E; Spears, Grant M et al. (2016) Risk factors for venous thromboembolism after acute trauma: A population-based case-cohort study. Thromb Res 144:40-5|
|Park, Myung S; Xue, Ailing; Spears, Grant M et al. (2015) Thrombin generation and procoagulant microparticle profiles after acute trauma: A prospective cohort study. J Trauma Acute Care Surg 79:726-31|
|Bingener, Juliane; Skaran, Pam; McConico, Andrea et al. (2015) A Double-Blinded Randomized Trial to Compare the Effectiveness of Minimally Invasive Procedures Using Patient-Reported Outcomes. J Am Coll Surg 221:111-21|
|Cohoon, Kevin P; Leibson, Cynthia L; Ransom, Jeanine E et al. (2015) Direct medical costs attributable to venous thromboembolism among persons hospitalized for major operation: a population-based longitudinal study. Surgery 157:423-31|
|Dhillon, Satbir K; Houck, Mindy L; Jenkins, Donald H et al. (2014) Transfusion of stored red blood cells in trauma patients is not associated with increased procoagulant microparticles. J Trauma Acute Care Surg 77:674-678|
|McCluskey, Susan V; Sztajnkrycer, Matthew D; Jenkins, Donald A et al. (2014) Stability of tranexamic acid in 0.9% sodium chloride, stored in type 1 glass vials and ethylene/propylene copolymer plastic containers. Int J Pharm Compd 18:432-7|
|Park, Myung S; Owen, Barbara A L; Ballinger, Beth A et al. (2012) Quantification of hypercoagulable state after blunt trauma: microparticle and thrombin generation are increased relative to injury severity, while standard markers are not. Surgery 151:831-6|