A Refined Phenomenological Model of Viscoelastic Clot Formation and Lysis in Trauma-Induced Coagulopathy

Abstract

Hyperfibrinolysis is strongly associated with early post-injury mortality, but the condition is preventable with timely detection and targeted interventions. Unfortunately, current hyperfibrinolysis diagnostic assays such as thromboelastography (TEG) are time-consuming, making them infeasible for use in real-time treatment strategies to guide adjustable, precise, and personalized interventions. Computational models offer a fast alternative to current practice for ascertaining patient hemostatic state from quickly-measurable protein concentrations. However, few models exist to predict clot strength. Our prior biologically-interpretable, phenomenological, dynamical system TEG model does not often satisfactorily capture hyperfibrinolysis because this feature was missing from training data. Here, we present model improvements that are experimentally-driven and theoretically-grounded to better facilitate the replacement of slow patient viscoelastic clotting measurements, with and without hyperfibrinolysis, by rapid and accurate predictions of TEG parameters in silico.