Evidence map›Paper›PMID 40517530›Full record

ArticleAmerican journal of surgery2025

Change in novel plasmin activated clotting time assay predicts hyperfibrinolysis, massive transfusion, and mortality in trauma in under 3 minutes.

Elizabeth R Maginot, Hunter B Moore, Ernest E Moore, Nicolle K Barmettler, Trace B Moody, Grace E Volk, Kyle S Sextro, Dylan C Hiser, Ashley A Clegg, Flobater I Gawargi and 6 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in American journal of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Elizabeth R MaginotDivision of Acute Care Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA.
Hunter B MooreDepartment of Surgery, AdventHealth Porter, Denver, CO, USA.
Ernest E MooreErnest E Moore Shock Trauma Center at Denver Health, Department of Surgery, Denver, CO, USA; Department of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Nicolle K BarmettlerDivision of Acute Care Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA.
Trace B MoodyDivision of Acute Care Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA.
Grace E VolkDivision of Acute Care Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA.
Kyle S SextroDivision of Acute Care Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA.
Dylan C HiserDivision of Acute Care Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA.
Ashley A CleggDivision of Acute Care Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA.
Flobater I GawargiDivision of Acute Care Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA.
Collin M WhiteDivision of Acute Care Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA; Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, NE, USA.
Reynold HenryDivision of Acute Care Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA.
James G ChandlerErnest E Moore Shock Trauma Center at Denver Health, Department of Surgery, Denver, CO, USA.
Michael B YaffeDivision of Acute Care Surgery, Trauma and Surgical Critical Care, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Koch Institute for Integrative Cancer Research, Center for Precision Cancer Medicine, Departments of Biological Engineering and Biology, Massachusetts Institute of Technology, Cambridge, MA, USA.
Trevor L NydamDepartment of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Christopher D BarrettDivision of Acute Care Surgery, Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA; Department of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, NE, USA. Electronic address: cbarrett@unmc.edu.

Funding

Using Patient-Reported Outcomes, Inflammatory Profiles, and Cardiovascular Phenogroups to Expand the Definition of Heart Failure with Preserved Ejection FractionP20GM152326 · NIGMS · UNIVERSITY OF NEBRASKA MEDICAL CENTER · PI Jason Rhede Cook · 2024 to 2026
$10.3M
Mechanisms of Complement Activation in Traumatic InjuryK08HL171936 · NHLBI · UNIVERSITY OF NEBRASKA MEDICAL CENTER · PI Christopher David Barrett · 2024 to 2026
$500k
NHLBI NIH HHS K08 HL171936NIGMS NIH HHS P20 GM152326
6 · The paper itself

Abstract

backgroundHyperfibrinolysis after trauma increases mortality, yet rapid identification remains a challenge. Prior work demonstrates liver transplantation is an idealized model of fibrinolysis. Early resource mobilization and antifibrinolytic therapy improves outcomes in trauma, but efficacy is lost with delays in care. We set out to develop a novel plasmin-activated clotting time (PACT) assay to rapidly diagnose hyperfibrinolysis.

methodsWhole blood from adult liver transplant(n ​= ​40) and trauma patients(n ​= ​32) underwent PACT assay alongside traditional and tPA-challenged thromboelastography(TEG). Primary outcomes of massive transfusion and early mortality were assessed.

resultsPACT accurately identified hyperfibrinolysis within 3 ​min during the anhepatic phase of liver transplant (35 ​% prevalence; p ​< ​0.001). In trauma, a PACT threshold (ΔACT >18.5 ​s) predicted massive transfusion or death (AUC ​= ​0.857, p ​< ​0.001), outperforming conventional TEG metrics (AUC<0.625).

conclusionThe PACT assay predicts hyperfibrinolysis, massive transfusion, and mortality in trauma patients in 3 ​min, offering potential for rapid resource triage and early targeted therapeutic administration.

Indexed as

Blood Coagulation DisordersBlood TransfusionFibrinolysinFibrinolysisWounds and InjuriesAdultAgedFemaleHumansMaleMiddle AgedPredictive Value of TestsThrombelastographyTime FactorsFibrinolysin

Identifiers

PMID40517530
PMCPMC13367528

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.