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- Title
The Hypercoagulable Profile of Patients with Bone Tumors: A Pilot Observational Study Using Rotational Thromboelastometry.
- Authors
Tsantes, Andreas G.; Loukopoulou, Ilectra; Papadopoulos, Dimitrios V.; Trikoupis, Ioannis G.; Roustemis, Anastasios G.; Goumenos, Stavros; Sokou, Rozeta; Tsante, Konstantina A.; Kriebardis, Anastasios G.; Koulouvaris, Panagiotis; Houhoula, Dimitra; Piovani, Daniele; Papagelopoulos, Panayiotis J.; Bonovas, Stefanos; Tsantes, Argirios E.
- Abstract
Simple Summary: Malignancy-associated coagulopathy (MAC) in surgical patients with bone tumors is associated with thromboembolic complications. Rotational thromboelastometry can provide a detailed evaluation of the mechanisms involved in MAC and may allow for more effective thromboprophylactic measures. The ROTEM results indicate that the hypercoagulable state in patients with bone tumors is caused by the malignancy-associated activation of the coagulation cascade, platelet activation, and hypofibrinolysis. Introduction: A detailed evaluation of the malignancy-associated coagulopathy (MAC) in surgical patients with bone tumors may allow for more effective thromboprophylactic measures. The purpose of this study was to assess the perioperative hemostatic changes in patients with bone tumors, using rotational thromboelastometry (ROTEM). Methods: An observational study was performed, including 50 patients with bone tumors who underwent oncologic resection and 30 healthy controls, matched for age and gender. The preoperative and postoperative laboratory evaluation of coagulation in both groups included conventional coagulation tests and a ROTEM analysis. The results of the conventional coagulation tests and the ROTEM analysis were compared between the two groups. Results: The results of the conventional coagulation tests were comparable between the tumor patients and the healthy controls. However, compared to the healthy adults, the tumor patients had lower CT (p < 0.001) and CFT (p < 0.001) values suggesting a rapid induction of the coagulation cascade, elevated A10 (p < 0.001) and MCF (p < 0.001) values indicating a higher clot strength and platelet activation, and elevated LI60 (p < 0.001) values indicating hypofibrinolysis in patients with bone tumors. The multiple linear regression analysis (controlling for potential confounding factors) confirmed the independent association of bone tumors with these hemostatic changes. Conclusions: Our results support the advantageous use of a ROTEM in patients with bone tumors over conventional coagulation tests because the qualitative changes in the hemostatic profile of these patients that can be detected by a ROTEM analysis cannot be identified by conventional tests. The ROTEM results indicate that the hypercoagulable state in patients with bone tumors is caused by the malignancy-associated activation of the coagulation cascade, platelet activation, and hypofibrinolysis.
- Subjects
PERIOPERATIVE care; SCIENTIFIC observation; BLOOD coagulation tests; MULTIPLE regression analysis; SURGERY; PATIENTS; THROMBELASTOGRAPHY; HEMOSTASIS; BLOOD coagulation; BONE tumors; BLOOD platelet activation; FIBRINOLYSIS; BLOOD coagulation disorders; DISEASE complications
- Publication
Cancers, 2022, Vol 14, Issue 16, p3930
- ISSN
2072-6694
- Publication type
Article
- DOI
10.3390/cancers14163930