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. 2022 Aug 1:10:100117.
doi: 10.1016/j.sipas.2022.100117. eCollection 2022 Sep.

Plasma thrombin generation kinetics in trauma patients across the age spectrum

Julie Goswami  1   2 , Taleen A MacArthur  1 , Cillian R Mahony  1 , Joseph Immermann  1 , Michael J Ferrara  1 , Denise B Klinkner  3 , Stephanie F Polites  3 , Beth A Ballinger  1 , Rosemary A Kozar  4 , Jing-Fei Dong  5 , Matthew T Auton  6 , Grant Spears  7 , Kent R Bailey  7 , Donald H Jenkins  8 , Myung S Park  1   9
Affiliations

Plasma thrombin generation kinetics in trauma patients across the age spectrum

Julie Goswami et al. Surg Pract Sci. .

Abstract

Background: Injured patients have early changes to normal coagulation that can impact long term risk for thrombotic complications. There is little known about how age impacts biomarkers of coagulation after traumatic injury. In this pilot study, we aimed to characterize thrombin generation kinetics, a known predictor of venous thromboembolism, in trauma patients across the age spectrum.

Methods: Citrated plasma samples were collected from 174 trauma patients (3-94 years old). Thrombin generation kinetics were measured using calibrated automated thrombogram (CAT) and expressed as lag time (LT - minutes) and time to peak (ttPeak - minutes). Kruskal-Wallis, Spearman correlation, and multivariable regression analysis were carried out. Data in median and quartiles [Q1, Q3]. P < 0.05 significant.

Results: Pediatric patients (n = 14) had shortest LT and ttPeak compared to adult and geriatric (n = 43), who had longest (LT: 2.67 [2.48, 3.00] vs. 2.93 [2.56, 3.48] vs. 3.15 [2.74, 3.67], p = 0.029; ttPeak: 4.98 [4.67, 5.67] vs. 5.53 [5.00, 6.56] vs. 5.94 [5.52, 6.91], p = 0.011). LT and ttPeak correlated with age (Spearman 0.285 and 0.305, both p < 0.001). Clinical factors, specifically, age, injury severity score, and transfusion status were associated with LT and ttPeak in multivariable models.

Conclusions: Trauma patients exhibit prolonged initiation and time to peak thrombin generation with age. Further studies are needed to determine the age-specific role of thrombin generation kinetics in thrombotic complications after trauma.

Keywords: Coagulopathy; Geriatric; Pediatric; Thrombin; Trauma.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig 1
Fig. 1
Flow Diagram and Age Range for Analyzed Subjects.
Fig 2
Fig. 2
Thrombin generation kinetics parameters by age group Calibrated automated thrombogram (CAT) parameters by age group. Pediatric defined as age 14 and under (n = 14), adult defined as age 15–64 (n = 117), and geriatric defined as age 65+ (n = 43). LT = lag time, PH = peak height, ttPeak = time to peak height. Values shown as median and quartiles (Q1, Q3). Kruskal-Wallis for 3-group comparison. Wilcoxon rank sum for 2-group comparison. p < 0.05 considered significant.
See this image and copyright information in PMC

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