Utility of point-of-care platelet aggregation testing for transfusion prediction
Shayan Rakhit1,2, Tyler J Murphy1,2, Karen Miller3
1Critical Illness, Brain Dysfunction, and Survivorship (CIBS) Center, Vanderbilt University Medical Center, Nashville, TN, USA.
Scientific Reports
|May 2, 2026
Summary
A new rapid platelet aggregation assay helped predict the need for blood transfusions in trauma patients. However, it did not significantly improve the prediction of life-threatening hemorrhage compared to standard clinical factors.
Area of Science:
- Trauma and Emergency Medicine
- Hematology
- Diagnostic Assay Development
Background:
- Early identification and treatment of life-threatening hemorrhage are critical for patient outcomes.
- Platelet dysfunction impairs hemostasis during major hemorrhage.
- Existing platelet function tests are often impractical for acute clinical settings.
Purpose of the Study:
- To prospectively evaluate a novel, rapid platelet aggregation assay for predicting life-threatening hemorrhage and transfusion needs in trauma patients.
- To compare the predictive performance of the novel assay against established clinical parameters and a combined model.
Main Methods:
- Prospective cohort study at a Level I trauma center including adult trauma activations (Level I or II).
- Assessed platelet aggregation using a prototype device as the primary exposure.
- Primary outcome: life-threatening hemorrhage; Secondary outcome: transfusion of >2 units of blood components.
- Multivariable regression analysis compared the assay, clinical parameters (BP, HR, mechanism), and a combined model.
Main Results:
- The platelet aggregation assay showed an AUC of 0.61 for predicting life-threatening hemorrhage, while clinical parameters had an AUC of 0.83.
- For predicting >2 units of blood transfusion, the assay yielded an AUC of 0.68, clinical parameters an AUC of 0.84, and the combined model an AUC of 0.88.
- The combined model significantly improved transfusion prediction (p=0.013) but not hemorrhage prediction (p=0.32) compared to clinical parameters alone.
Conclusions:
- A novel rapid platelet aggregation assay enhanced prediction of blood transfusion needs in trauma patients when combined with clinical parameters.
- The assay did not significantly improve the prediction of life-threatening hemorrhage.
- Further validation in larger cohorts and diverse patient populations (including non-traumatic hemorrhage) is warranted to establish clinical utility.
