The venous thromboembolic risk and the clot wave analysis: a useful relationship?

被引:16
作者
Ruberto, Maria Filomena [2 ]
Marongiu, Francesco [1 ]
Mandas, Antonella [2 ]
Mameli, Antonella [2 ]
Porru, Mariagrazia [2 ]
Cianchetti, Elisabetta [2 ]
Barcellona, Doris [2 ]
机构
[1] Univ Cagliari, Dept Med Sci & Publ Hlth, Internal Med & Haemostasis & Thrombosis Unit, Cagliari, Italy
[2] Univ Cagliari, Dept Med Sci & Publ Hlth, Cagliari, Italy
关键词
aPTT derivatives; clot wave analysis; D-Dimer; fibrinogen; internal medicine ward; Padua Prediction Score; PADUA PREDICTION SCORE; FORM ANALYSIS; D-DIMER; CLINICAL-APPLICATIONS; LIVER-CIRRHOSIS; CANCER-PATIENTS; IDENTIFICATION; COAGULATION; THROMBOSIS; ASSAYS;
D O I
10.1515/cclm-2017-0678
中图分类号
R446 [实验室诊断]; R-33 [实验医学、医学实验];
学科分类号
1001 ;
摘要
Background: Hospitalized patients with acute medical conditions have higher venous thromboembolism (VTE) risk. A patient with a final Padua Prediction Score (PPS) of >= 4 is considered to be at high risk for VTE. The aim of this study was to investigate on a possible relationship between PPS, the dynamics of the clot formation, i.e. the clot waveform analysis (CWA) of aPTT, fibrinogen and D-Dimer in a large group of medical patients. Methods: CWA in terms of velocity (first derivative), acceleration (second derivative), density (Delta) of aPTT, fibrinogen, D-Dimer and PPS for VTE were determined in 801 medical patients divided in three groups (without antithrombotic prophylaxis and high PPS, without antithrombotic prophylaxis and low PPS, with antithrombotic prophylaxis and high PPS) and a group of healthy subjects. Results: CWA, fibrinogen and D-Dimer values were higher in the medical patients with high PPS with or without antithrombotic prophylaxis when compared with patients without antithrombotic prophylaxis with low PPS and healthy subjects. The second derivative, fibrinogen and D-Dimer were significantly associated with a high PPS score (>= 4): odds ratio (OR) = 1.53, 95% confidence interval (CI) = 1.03-2.28; OR = 1.91, 95% CI = 1.3-2.79; OR = 3.16, 95% CI = 2.29-4.36, respectively. Interactions between first derivative and D-Dimer (OR = 2.14, 95% CI = 1.23-3.72) and first derivative and fibrinogen (OR = 1.75, 95% CI = 1.022.98) were found. Conclusions: CWA could give useful information to recognize a hypercoagulable state in patients admitted to a medical ward with high and low PPS. First and second derivative aPTT, D-Dimer and fibrinogen levels could be added to PPS to better assess the global thromboembolic risk of these patients.
引用
收藏
页码:448 / 453
页数:6
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