Document Detail


Splenectomy leads to a persistent hypercoagulable state after trauma.
MedLine Citation:
PMID:  20466110     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Jennifer M Watters; Chitra N Sambasivan; Karen Zink; Igor Kremenevskiy; Michael S Englehart; Samantha J Underwood; Martin A Schreiber
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of surgery     Volume:  199     ISSN:  1879-1883     ISO Abbreviation:  Am. J. Surg.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-14     Completed Date:  2010-06-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370473     Medline TA:  Am J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  646-51     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010 Elsevier Inc. All rights reserved.
Affiliation:
Department of Surgery, Division of Trauma, Critical Care and Acute Care Surgery, Oregon Health and Science University, Portland, OR, USA. wattersj@ohsu.edu
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MeSH Terms
Descriptor/Qualifier:
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:
5 M01 RR00334/RR/NCRR NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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