TY - JOUR
T1 - Splenectomy leads to a persistent hypercoagulable state after trauma
AU - Watters, Jennifer M.
AU - Sambasivan, Chitra N.
AU - Zink, Karen
AU - Kremenevskiy, Igor
AU - Englehart, Michael S.
AU - Underwood, Samantha J.
AU - Schreiber, Martin A.
PY - 2010/5
Y1 - 2010/5
N2 - 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.
AB - 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.
KW - Hypercoagulable
KW - Splenectomy
KW - Thromboelastography
KW - Thromboembolism
KW - Trauma
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U2 - 10.1016/j.amjsurg.2010.01.015
DO - 10.1016/j.amjsurg.2010.01.015
M3 - Article
C2 - 20466110
AN - SCOPUS:77951928091
SN - 0002-9610
VL - 199
SP - 646
EP - 651
JO - American journal of surgery
JF - American journal of surgery
IS - 5
ER -