Splenectomy leads to a persistent hypercoagulable state after trauma.

Abstract:

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.

journal_name

Am J Surg

authors

Watters JM,Sambasivan CN,Zink K,Kremenevskiy I,Englehart MS,Underwood SJ,Schreiber MA

doi

10.1016/j.amjsurg.2010.01.015

subject

Has Abstract

pub_date

2010-05-01 00:00:00

pages

646-51

issue

5

eissn

0002-9610

issn

1879-1883

pii

S0002-9610(10)00049-8

journal_volume

199

pub_type

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