Splenectomy leads to a persistent hypercoagulable state after trauma - 19/08/11
, Chitra N. Sambasivan, M.D., Karen Zink, M.D., Igor Kremenevskiy, M.D., Ph.D., Michael S. Englehart, M.D., Samantha J. Underwood, M.S., Martin A. Schreiber, M.D.
Corresponding author. Tel.: 503-494-5300; fax: 503-494-6519Abstract |
Background |
It was hypothesized that splenectomy following trauma results in hypercoagulability.
Methods |
A prospective, nonrandomized, single-center study was performed to evaluate coagulation parameters in trauma patients with splenic injury.
Results |
Patients with splenectomy (n = 30) and nonoperative management (n = 50) were enrolled. Splenectomy patients were older, had higher Injury Severity Scores, and had longer intensive care unit and hospital stays (P < .05). Splenectomy patients had significantly increased white blood cell counts and platelet counts at baseline and follow-up (P < .01). Fibrinogen was initially elevated in both groups and remained elevated in the splenectomy group (P < .05). Tissue plasminogen activator, plasminogen activator inhibitor–1, and activated partial thromboplastin time were higher in splenectomy patients only at baseline (P < .05). Baseline thromboelastography showed faster fibrin cross-linking and enhanced fibrinolysis following splenectomy (P < .05). Only clot strength was greater at follow-up in the splenectomy group (P < .01). Deep venous thrombosis developed in 7% of splenectomy patients and no control patients (P = .03).
Conclusions |
A significant difference in deep venous thrombosis formation was noted, and coagulation assays indicated persistent hypercoagulability following splenectomy for trauma.
Le texte complet de cet article est disponible en PDF.Keywords : Trauma, Splenectomy, Thromboembolism, Hypercoagulable, Thromboelastography
Plan
| This publication was made possible with support from the Oregon Clinical and Translational Research Institute; grant 5 M01 RR00334 from the National Center for Research Resources, a component of the National Institutes of Health; and the National Institutes of Health Roadmap for Medical Research. |
Vol 199 - N° 5
P. 646-651 - mai 2010 Retour au numéro
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