| Splenectomy leads to a persistent hypercoagulable state after trauma. | |
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MedLine Citation:
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PMID: 20466110 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Jennifer M Watters; Chitra N Sambasivan; Karen Zink; Igor Kremenevskiy; Michael S Englehart; Samantha J Underwood; Martin A Schreiber |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: American journal of surgery Volume: 199 ISSN: 1879-1883 ISO Abbreviation: Am. J. Surg. Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-05-14 Completed Date: 2010-06-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370473 Medline TA: Am J Surg Country: United States |
Other Details:
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Languages: eng Pagination: 646-51 Citation Subset: AIM; IM |
Copyright Information:
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Copyright 2010 Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Surgery, Division of Trauma, Critical Care and Acute Care Surgery, Oregon Health and Science University, Portland, OR, USA. wattersj@ohsu.edu |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Blood Chemical Analysis Blood Coagulation Disorders / epidemiology, etiology Cohort Studies Female Follow-Up Studies Humans Incidence Injury Severity Score Male Multiple Trauma / diagnosis, mortality, surgery* Platelet Count Probability Prospective Studies Prothrombin Time Reference Values Risk Assessment Splenectomy / adverse effects*, methods Thrombophilia / epidemiology*, etiology Thrombosis / epidemiology, etiology* Wounds and Injuries / diagnosis, surgery* |
| Grant Support | |
ID/Acronym/Agency:
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5 M01 RR00334/RR/NCRR NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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