Document Detail

Alterations of the preoperative coagulation profile in patients with acute appendicitis.
MedLine Citation:
PMID:  21663567     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Acute appendicitis (AA) is usually associated with a systemic inflammatory response that often leads to activation of coagulation. However, limited data about coagulation changes in AA are available.
METHODS: Results of preoperative coagulation testing in 702 patients with confirmed AA and 697 patients undergoing minor elective surgery (control) during the same period were analyzed retrospectively. Coagulation activity of factors VII, IX (FVII:C, FIX:C) and the concentration of plasma endotoxin from 40 patients with AA and 15 control subjects were measured.
RESULTS: Compared with control subjects, prothrombin time (PT), fibrinogen (Fib) and endotoxin increased (all p<0.01), FVII:C decreased (p<0.05), and thrombin time shortened (p<0.01) significantly in patients with AA, which showed trends with increasing severity of disease. Areas under the receiver operating characteristic curve of Fib for discriminating complicated appendicitis or acute perforated appendicitis from enrolled patients were larger than those for leukocyte parameters. The concentration of endotoxin correlated negatively with FVII:C (r=-0.860, p<0.001), positively with PT (0.713, <0.001), and FVII:C negatively with PT (-0.729, <0.001) in individuals that were evaluated. The change in activated partial thromboplastin time and difference in FIX:C among patients with various pathological types of appendicitis were not significant.
CONCLUSIONS: Endotoxin-induced activation of the extrinsic coagulation pathway was present in patients with AA. Fib may be useful as a potential indicator for excluding complicated appendicitis.
Jianxin Li; Yan Liu; Weihua Yin; Chuanzhou Zhang; Jinhe Huang; Chaoyu Liao; Liping Nie; Yu Zhou; Ping Xiao
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-06-13
Journal Detail:
Title:  Clinical chemistry and laboratory medicine : CCLM / FESCC     Volume:  49     ISSN:  1434-6621     ISO Abbreviation:  Clin. Chem. Lab. Med.     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-08-04     Completed Date:  2011-11-29     Revised Date:  2012-03-25    
Medline Journal Info:
Nlm Unique ID:  9806306     Medline TA:  Clin Chem Lab Med     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  1333-9     Citation Subset:  IM    
Department of Laboratory Medicine, Peking University Shenzhen Hospital, Shenzhen, PR China.
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MeSH Terms
Acute Disease
Appendicitis / blood*,  complications
Area Under Curve
Bacteremia / complications
Blood Coagulation Tests
Endotoxins / blood
Factor VII / metabolism
Factor X / metabolism
Fibrinogen / analysis
Middle Aged
Preoperative Period
Prothrombin Time
Retrospective Studies
Reg. No./Substance:
0/Endotoxins; 9001-25-6/Factor VII; 9001-29-0/Factor X; 9001-32-5/Fibrinogen

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