Cargando…

Multiplate Platelet Function Testing upon Emergency Room Admission Fails to Provide Useful Information in Major Trauma Patients Not on Platelet Inhibitors

Platelet dysfunction is a suggested driver of trauma-induced coagulopathy. However, there is still a paucity of data regarding the impact of injury pattern on platelet function and the association of platelet dysfunction on transfusion requirements and mortality. In this retrospective cohort study,...

Descripción completa

Detalles Bibliográficos
Autores principales: Pommer, Peter, Oberladstätter, Daniel, Schlimp, Christoph J., Zipperle, Johannes, Voelckel, Wolfgang, Lockie, Christopher, Osuchowski, Marcin, Schöchl, Herbert
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9100631/
https://www.ncbi.nlm.nih.gov/pubmed/35566704
http://dx.doi.org/10.3390/jcm11092578
_version_ 1784706892854984704
author Pommer, Peter
Oberladstätter, Daniel
Schlimp, Christoph J.
Zipperle, Johannes
Voelckel, Wolfgang
Lockie, Christopher
Osuchowski, Marcin
Schöchl, Herbert
author_facet Pommer, Peter
Oberladstätter, Daniel
Schlimp, Christoph J.
Zipperle, Johannes
Voelckel, Wolfgang
Lockie, Christopher
Osuchowski, Marcin
Schöchl, Herbert
author_sort Pommer, Peter
collection PubMed
description Platelet dysfunction is a suggested driver of trauma-induced coagulopathy. However, there is still a paucity of data regarding the impact of injury pattern on platelet function and the association of platelet dysfunction on transfusion requirements and mortality. In this retrospective cohort study, patients were grouped into those with isolated severe traumatic brain injury (TBI group), those with major trauma without TBI (MT group), and a combination of both major trauma and traumatic brain injury (MT + TBI group). Platelet function was assessed by whole blood impedance aggregometry (Multiplate(®), MP). Three different platelet activators were used: adenosine-diphosphate (ADP test), arachidonic acid (ASPI test), and thrombin activated peptide-6 (TRAP test). Blood transfusion requirements within 6 h and 24 h and the association of platelet dysfunction on mortality was investigated. A total of 328 predominantly male patients (75.3%) with a median age of 53 (37–68) years and a median ISS of 29 (22–38) were included. No significant difference between the TBI group, the MT group, and the MT + TBI group was detected for any of the investigated platelet function tests. Unadjusted and adjusted for platelet count, the investigated MP assays revealed no significant group differences upon ER admission and were not able to sufficiently predict massive transfusion, neither within the first 6 h nor for the first 24 h after hospital admission. No association between platelet dysfunction measured by MP upon ER admission and mortality was observed. Conclusion: Injury pattern did not specifically impact platelet function measurable by MP. Platelet dysfunction upon ER admission measurable by MP was not associated with transfusion requirements and mortality. The clinical relevance of platelet function testing by MP in trauma patients not on platelet inhibitors is questionable.
format Online
Article
Text
id pubmed-9100631
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-91006312022-05-14 Multiplate Platelet Function Testing upon Emergency Room Admission Fails to Provide Useful Information in Major Trauma Patients Not on Platelet Inhibitors Pommer, Peter Oberladstätter, Daniel Schlimp, Christoph J. Zipperle, Johannes Voelckel, Wolfgang Lockie, Christopher Osuchowski, Marcin Schöchl, Herbert J Clin Med Article Platelet dysfunction is a suggested driver of trauma-induced coagulopathy. However, there is still a paucity of data regarding the impact of injury pattern on platelet function and the association of platelet dysfunction on transfusion requirements and mortality. In this retrospective cohort study, patients were grouped into those with isolated severe traumatic brain injury (TBI group), those with major trauma without TBI (MT group), and a combination of both major trauma and traumatic brain injury (MT + TBI group). Platelet function was assessed by whole blood impedance aggregometry (Multiplate(®), MP). Three different platelet activators were used: adenosine-diphosphate (ADP test), arachidonic acid (ASPI test), and thrombin activated peptide-6 (TRAP test). Blood transfusion requirements within 6 h and 24 h and the association of platelet dysfunction on mortality was investigated. A total of 328 predominantly male patients (75.3%) with a median age of 53 (37–68) years and a median ISS of 29 (22–38) were included. No significant difference between the TBI group, the MT group, and the MT + TBI group was detected for any of the investigated platelet function tests. Unadjusted and adjusted for platelet count, the investigated MP assays revealed no significant group differences upon ER admission and were not able to sufficiently predict massive transfusion, neither within the first 6 h nor for the first 24 h after hospital admission. No association between platelet dysfunction measured by MP upon ER admission and mortality was observed. Conclusion: Injury pattern did not specifically impact platelet function measurable by MP. Platelet dysfunction upon ER admission measurable by MP was not associated with transfusion requirements and mortality. The clinical relevance of platelet function testing by MP in trauma patients not on platelet inhibitors is questionable. MDPI 2022-05-05 /pmc/articles/PMC9100631/ /pubmed/35566704 http://dx.doi.org/10.3390/jcm11092578 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pommer, Peter
Oberladstätter, Daniel
Schlimp, Christoph J.
Zipperle, Johannes
Voelckel, Wolfgang
Lockie, Christopher
Osuchowski, Marcin
Schöchl, Herbert
Multiplate Platelet Function Testing upon Emergency Room Admission Fails to Provide Useful Information in Major Trauma Patients Not on Platelet Inhibitors
title Multiplate Platelet Function Testing upon Emergency Room Admission Fails to Provide Useful Information in Major Trauma Patients Not on Platelet Inhibitors
title_full Multiplate Platelet Function Testing upon Emergency Room Admission Fails to Provide Useful Information in Major Trauma Patients Not on Platelet Inhibitors
title_fullStr Multiplate Platelet Function Testing upon Emergency Room Admission Fails to Provide Useful Information in Major Trauma Patients Not on Platelet Inhibitors
title_full_unstemmed Multiplate Platelet Function Testing upon Emergency Room Admission Fails to Provide Useful Information in Major Trauma Patients Not on Platelet Inhibitors
title_short Multiplate Platelet Function Testing upon Emergency Room Admission Fails to Provide Useful Information in Major Trauma Patients Not on Platelet Inhibitors
title_sort multiplate platelet function testing upon emergency room admission fails to provide useful information in major trauma patients not on platelet inhibitors
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9100631/
https://www.ncbi.nlm.nih.gov/pubmed/35566704
http://dx.doi.org/10.3390/jcm11092578
work_keys_str_mv AT pommerpeter multiplateplateletfunctiontestinguponemergencyroomadmissionfailstoprovideusefulinformationinmajortraumapatientsnotonplateletinhibitors
AT oberladstatterdaniel multiplateplateletfunctiontestinguponemergencyroomadmissionfailstoprovideusefulinformationinmajortraumapatientsnotonplateletinhibitors
AT schlimpchristophj multiplateplateletfunctiontestinguponemergencyroomadmissionfailstoprovideusefulinformationinmajortraumapatientsnotonplateletinhibitors
AT zipperlejohannes multiplateplateletfunctiontestinguponemergencyroomadmissionfailstoprovideusefulinformationinmajortraumapatientsnotonplateletinhibitors
AT voelckelwolfgang multiplateplateletfunctiontestinguponemergencyroomadmissionfailstoprovideusefulinformationinmajortraumapatientsnotonplateletinhibitors
AT lockiechristopher multiplateplateletfunctiontestinguponemergencyroomadmissionfailstoprovideusefulinformationinmajortraumapatientsnotonplateletinhibitors
AT osuchowskimarcin multiplateplateletfunctiontestinguponemergencyroomadmissionfailstoprovideusefulinformationinmajortraumapatientsnotonplateletinhibitors
AT schochlherbert multiplateplateletfunctiontestinguponemergencyroomadmissionfailstoprovideusefulinformationinmajortraumapatientsnotonplateletinhibitors