Analysis of hemostasis of aged trauma patients and investigation for noble biomarker related to hemostasis

• Project/Area Number: 25893016
• Research Category: Grant-in-Aid for Research Activity Start-up
• Allocation Type: Single-year Grants
• Research Field: Emergency medicine
• Research Institution: Tohoku University
• Principal Investigator: KUDO Daisuke 東北大学, 医学(系)研究科(研究院), 助教 (30455844)
• Project Period (FY): 2013-08-30 – 2015-03-31
• Project Status: Completed (Fiscal Year 2014)
• Budget Amount: ¥2,730,000 (Direct Cost: ¥2,100,000、Indirect Cost: ¥630,000); Fiscal Year 2014: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000); Fiscal Year 2013: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
• Keywords: 外傷 / 凝固 / 止血 / 血液凝固 / 高齢者

Outline of Final Research Achievements

Actual ability of hemostasis can be measured by Rotation Thromboelastometry [ROTEM delta Tem (International GmbH)] examination. Correlation between actual ability of hemostasis and common coagulation markers was investigated in the patients with severe trauma. Seven (43.8%) of 16 patients who showed normal range of coagulation markers, represented decreased ability of hemostasis by ROTEM examination. Five of 7 had severe brain injury and included both young and old patients.
These results showed that it is difficult to evaluate ability to hemostasis not only by the common coagulation markers. Further investigation is required to effectiveness of ROTEM examination on outcome in the patients with severe trauma.

Research Products

• [Journal Article] Damage Control Resuscitaion-重症外傷の凝固線溶異常に対する蘇生のすべて-. フィブリノゲン製剤 (2014)
  • Author(s): 工藤大介、大邊寛幸、久志本成樹
  • Journal Title: 救急・集中治療 Volume: 7,8 Pages: 1137-1144
• [Journal Article] 外傷性血液凝固障害への挑戦 (2014)
  • Author(s): 久志本成樹、工藤大介、藤田基生、前澤翔太、赤石敏
  • Journal Title: Current Therapy Volume: 8 Pages: 29-37
• [Journal Article] 外傷急性期凝固異常の早期予測. 外傷蘇生のControversies救急医学 (2013)
  • Author(s): 久志本成樹、工藤大介、大村拓、眞田千穂
  • Journal Title: 救急医学 Volume: 37 Pages: 568-574
• [Presentation] Decreased ADAMTS13 activity is associated with increased mortality and poor neurological outcome in patients with successful resuscitation after out-of-hospital cardiac arrest (2015)
  • Author(s): Daisuke Kudo, Hiroyuki Obe, Taku Omura, Satoshi Yamanouchi, Tomoyuki Endo, Takeaki Sato, Ryosuke Nomura, Shigeki Kushimoto
  • Organizer: 44th Critical Care Congress
  • Place of Presentation: Phoenix (the United States)
  • Year and Date: 2015-01-18 – 2015-01-21
• [Presentation] 重症敗血症における炎症、免疫応答および凝固線溶反応は年齢により異なる (2014)
  • Author(s): 工藤大介、山内聡、野村亮介、久志本成樹
  • Organizer: 第42日本救急医学会学術集会
  • Place of Presentation: 福岡国際会議場（福岡）
  • Year and Date: 2014-10-28 – 2014-10-30
• [Presentation] Rotation Thromboelastometry (ROTEM)による凝固異常の評価をもとに出血制御戦略を施行した多発外傷の2例 (2014)
  • Author(s): 竹越大輔、工藤大介、中川敦寛、大村拓、久志本成樹
  • Organizer: 第17回日本臨床救急医学会学術集会
  • Place of Presentation: 栃木県下野市