Splenectomy leads to a persistent hypercoagulable state after trauma

Jennifer M. Watters, Chitra N. Sambasivan, Karen Zink, Igor Kremenevskiy, Michael S. Englehart, Samantha J. Underwood, Martin A. Schreiber

    Research output: Contribution to journalArticlepeer-review

    38 Scopus citations

    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.

    Original languageEnglish (US)
    Pages (from-to)646-651
    Number of pages6
    JournalAmerican journal of surgery
    Volume199
    Issue number5
    DOIs
    StatePublished - May 2010

    Keywords

    • Hypercoagulable
    • Splenectomy
    • Thromboelastography
    • Thromboembolism
    • Trauma

    ASJC Scopus subject areas

    • Surgery

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