The Hypercoagulable Profile of Patients with Bone Tumors: A Pilot Observational Study Using Rotational Thromboelastometry
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 rotati...
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2022-08-01
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| author | Andreas G. Tsantes Ilectra Loukopoulou Dimitrios V. Papadopoulos Ioannis G. Trikoupis Anastasios G. Roustemis Stavros Goumenos Rozeta Sokou Konstantina A. Tsante Anastasios G. Kriebardis Panagiotis Koulouvaris Dimitra Houhoula Daniele Piovani Panayiotis J. Papagelopoulos Stefanos Bonovas Argirios E. Tsantes |
| author_facet | Andreas G. Tsantes Ilectra Loukopoulou Dimitrios V. Papadopoulos Ioannis G. Trikoupis Anastasios G. Roustemis Stavros Goumenos Rozeta Sokou Konstantina A. Tsante Anastasios G. Kriebardis Panagiotis Koulouvaris Dimitra Houhoula Daniele Piovani Panayiotis J. Papagelopoulos Stefanos Bonovas Argirios E. Tsantes |
| author_sort | Andreas G. Tsantes |
| collection | DOAJ |
| description | 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 (<i>p</i> < 0.001) and CFT (<i>p</i> < 0.001) values suggesting a rapid induction of the coagulation cascade, elevated A10 (<i>p</i> < 0.001) and MCF (<i>p</i> < 0.001) values indicating a higher clot strength and platelet activation, and elevated LI60 (<i>p</i> < 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. |
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| spelling | doaj.art-ed6930a497d0438c8f619e75bb64164a2023-12-03T13:24:59ZengMDPI AGCancers2072-66942022-08-011416393010.3390/cancers14163930The Hypercoagulable Profile of Patients with Bone Tumors: A Pilot Observational Study Using Rotational ThromboelastometryAndreas G. Tsantes0Ilectra Loukopoulou1Dimitrios V. Papadopoulos2Ioannis G. Trikoupis3Anastasios G. Roustemis4Stavros Goumenos5Rozeta Sokou6Konstantina A. Tsante7Anastasios G. Kriebardis8Panagiotis Koulouvaris9Dimitra Houhoula10Daniele Piovani11Panayiotis J. Papagelopoulos12Stefanos Bonovas13Argirios E. Tsantes14Laboratory of Haematology and Blood Bank Unit, “Attiko” Hospital, School of Medicine, National and Kapodistrian University of Athens, 15772 Athens, GreeceLaboratory of Haematology and Blood Bank Unit, “Attiko” Hospital, School of Medicine, National and Kapodistrian University of Athens, 15772 Athens, GreeceDepartment of Orthopaedic Surgery, Geisinger Medical Center, Danville, PA 17822, USAFirst Department of Orthopaedics, School of Medicine, National and Kapodistrian University of Athens, 15772 Athens, GreeceFirst Department of Orthopaedics, School of Medicine, National and Kapodistrian University of Athens, 15772 Athens, GreeceFirst Department of Orthopaedics, School of Medicine, National and Kapodistrian University of Athens, 15772 Athens, GreeceLaboratory of Haematology and Blood Bank Unit, “Attiko” Hospital, School of Medicine, National and Kapodistrian University of Athens, 15772 Athens, GreeceLaboratory of Haematology and Blood Bank Unit, “Attiko” Hospital, School of Medicine, National and Kapodistrian University of Athens, 15772 Athens, GreeceLaboratory of Reliability and Quality Control in Laboratory Hematology, Department of Biomedical Science, School of Health and Caring Science, University of West Attica, 12243 Athens, GreeceFirst Department of Orthopaedics, School of Medicine, National and Kapodistrian University of Athens, 15772 Athens, GreeceLaboratory of Haematology and Blood Bank Unit, “Attiko” Hospital, School of Medicine, National and Kapodistrian University of Athens, 15772 Athens, GreeceDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, ItalyFirst Department of Orthopaedics, School of Medicine, National and Kapodistrian University of Athens, 15772 Athens, GreeceDepartment of Biomedical Sciences, Humanitas University, Pieve Emanuele, 20072 Milan, ItalyLaboratory of Haematology and Blood Bank Unit, “Attiko” Hospital, School of Medicine, National and Kapodistrian University of Athens, 15772 Athens, GreeceIntroduction: 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 (<i>p</i> < 0.001) and CFT (<i>p</i> < 0.001) values suggesting a rapid induction of the coagulation cascade, elevated A10 (<i>p</i> < 0.001) and MCF (<i>p</i> < 0.001) values indicating a higher clot strength and platelet activation, and elevated LI60 (<i>p</i> < 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.https://www.mdpi.com/2072-6694/14/16/3930malignancy-associated coagulopathyrotational thromboelastometrybone tumorshypercoagulabilityhypofibrinolysis |
| spellingShingle | Andreas G. Tsantes Ilectra Loukopoulou Dimitrios V. Papadopoulos Ioannis G. Trikoupis Anastasios G. Roustemis Stavros Goumenos Rozeta Sokou Konstantina A. Tsante Anastasios G. Kriebardis Panagiotis Koulouvaris Dimitra Houhoula Daniele Piovani Panayiotis J. Papagelopoulos Stefanos Bonovas Argirios E. Tsantes The Hypercoagulable Profile of Patients with Bone Tumors: A Pilot Observational Study Using Rotational Thromboelastometry Cancers malignancy-associated coagulopathy rotational thromboelastometry bone tumors hypercoagulability hypofibrinolysis |
| title | The Hypercoagulable Profile of Patients with Bone Tumors: A Pilot Observational Study Using Rotational Thromboelastometry |
| title_full | The Hypercoagulable Profile of Patients with Bone Tumors: A Pilot Observational Study Using Rotational Thromboelastometry |
| title_fullStr | The Hypercoagulable Profile of Patients with Bone Tumors: A Pilot Observational Study Using Rotational Thromboelastometry |
| title_full_unstemmed | The Hypercoagulable Profile of Patients with Bone Tumors: A Pilot Observational Study Using Rotational Thromboelastometry |
| title_short | The Hypercoagulable Profile of Patients with Bone Tumors: A Pilot Observational Study Using Rotational Thromboelastometry |
| title_sort | hypercoagulable profile of patients with bone tumors a pilot observational study using rotational thromboelastometry |
| topic | malignancy-associated coagulopathy rotational thromboelastometry bone tumors hypercoagulability hypofibrinolysis |
| url | https://www.mdpi.com/2072-6694/14/16/3930 |
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