Shock. 2026 Mar 20. doi: 10.1097/SHK.0000000000002725. Online ahead of print.
ABSTRACT
INTRODUCTION: Calibrated automated thrombography (CAT) assay parameters have been shown to assess hypercoagulation state and, therefore, may independently predict post-trauma, symptomatic venous thromboembolism (VTE). Yet, CAT lacks high throughput and standardization, limiting diagnostic potential. This study analyzed thrombin generation profiles in trauma patients using a high throughput assay, processing up to 10 samples at once, providing batch testing capabilities. We hypothesized that trauma patients who developed VTE would show distinct thrombin generation profiles compared to those who did not.
METHODS: Trauma patients presenting to a Level I Trauma Center had samples collected within 12 hours post-injury prospectively. Follow-up was conducted to 90 days, time to symptomatic VTE diagnosis or death, confirmed via autopsy or imaging. Thrombin generation profiles were measured from the ST Genesia assay. Data was presented as median [IQR] or n (%), with Wilcoxon rank-sum or chi-squared test. Associations between thrombin generation parameters and clinical risk factors were assessed using Spearman correlation analysis or the Wilcoxon rank-sum test.
RESULTS: Two-hundred and fifty-four trauma patients were analyzed (48.5 years [31.0, 62.0], 72.0% male): 64 patients with VTE (25.2%) to 190 with non-VTE. VTE pts had a median time to VTE of 8 days, with 29 developing deep venous thrombosis (DVT), 24 with pulmonary embolism (PE), and 11 with DVT/PEs. No significant differences were found in age, sex, or Body Mass Index (BMI); significantly more VTE patients underwent surgery and blood transfusions within 24 hours. Thrombin generation profiles demonstrated accelerated thrombin generation in patients who developed VTE compared to non-VTE, with significant differences in Peak Height (p=0.001), Time to Peak (p=0.021), Endogenous Thrombin Potential (p<0.001) and Velocity Index (p=0.001).
CONCLUSION: Thrombin generation profiles using ST Genesia can differentiate trauma patients at high risk of developing VTE. The platform suits clinical labs needing high throughput by providing batch testing capabilities.Study Type: Prospective study with less than large effect and no negative criteria.Level of Evidence: II.
PMID:41949808 | DOI:10.1097/SHK.0000000000002725
