Splenectomy leads to a persistent hypercoagulable state after trauma

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

    Research output: Contribution to journalArticle

    32 Citations (Scopus)

    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

    Fingerprint

    Splenectomy
    Wounds and Injuries
    Thrombophilia
    Venous Thrombosis
    Thrombelastography
    Injury Severity Score
    Partial Thromboplastin Time
    Plasminogen Activator Inhibitor 1
    Fibrinolysis
    Tissue Plasminogen Activator
    Fibrin
    Platelet Count
    Leukocyte Count
    Fibrinogen
    Intensive Care Units
    Length of Stay
    Blood Platelets

    Keywords

    • Hypercoagulable
    • Splenectomy
    • Thromboelastography
    • Thromboembolism
    • Trauma

    ASJC Scopus subject areas

    • Surgery

    Cite this

    Watters, J., Sambasivan, C. N., Zink, K., Kremenevskiy, I., Englehart, M. S., Underwood, S. J., & Schreiber, M. (2010). Splenectomy leads to a persistent hypercoagulable state after trauma. American Journal of Surgery, 199(5), 646-651. https://doi.org/10.1016/j.amjsurg.2010.01.015

    Splenectomy leads to a persistent hypercoagulable state after trauma. / Watters, Jennifer; Sambasivan, Chitra N.; Zink, Karen; Kremenevskiy, Igor; Englehart, Michael S.; Underwood, Samantha J.; Schreiber, Martin.

    In: American Journal of Surgery, Vol. 199, No. 5, 05.2010, p. 646-651.

    Research output: Contribution to journalArticle

    Watters, J, Sambasivan, CN, Zink, K, Kremenevskiy, I, Englehart, MS, Underwood, SJ & Schreiber, M 2010, 'Splenectomy leads to a persistent hypercoagulable state after trauma', American Journal of Surgery, vol. 199, no. 5, pp. 646-651. https://doi.org/10.1016/j.amjsurg.2010.01.015
    Watters J, Sambasivan CN, Zink K, Kremenevskiy I, Englehart MS, Underwood SJ et al. Splenectomy leads to a persistent hypercoagulable state after trauma. American Journal of Surgery. 2010 May;199(5):646-651. https://doi.org/10.1016/j.amjsurg.2010.01.015
    Watters, Jennifer ; Sambasivan, Chitra N. ; Zink, Karen ; Kremenevskiy, Igor ; Englehart, Michael S. ; Underwood, Samantha J. ; Schreiber, Martin. / Splenectomy leads to a persistent hypercoagulable state after trauma. In: American Journal of Surgery. 2010 ; Vol. 199, No. 5. pp. 646-651.
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