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Hemostatic parameters in patients with spinal cord injury in subacute and chronic phase of the rehabilitation
The Journal of Spinal Cord Medicine ( IF 1.8 ) Pub Date : 2020-02-03 , DOI: 10.1080/10790268.2019.1708600
Magdalena Mackiewicz-Milewska 1 , Andrzej Kroszczynski 2 , Małgorzata Cisowska-Adamiak 1 , Jerzy Pyskir 3 , Danuta Rosc 4 , Wojciech Hagner 1
Affiliation  

Objective: The goal of this study was to measure hemostatic markers after SCI.

Design: Assesing changes in coagulation and fibrynilitic system in SCI patients in different time post injury to Cross-sectional study.

Setting: Rehabilitation Department of the Bydgoszcz University Hospital, Poland from 2011 to 2017.

Participants: SCI patient during acute and chronic rehabilitation (N = 88).

Outcome Measures: Assesing following parameters: platelet counts and levels of D-dimer, antithrombin III (ATIII), tissue factor (TF), tissue factor pathway inhibitor (TFPI) and the inflammatory marker, C-reactive protein (CRP).

Interventions: Eighty-eight SCI patients were divided into three groups based on the time elapsed from injury: group I (three weeks to three months), group II (three to twelve months) and group III (more than twelve months). All patients underwent ultrasonography (US) to detect acute or chronic recanalized deep vein thrombosis (DVT). Platelet counts and levels of D-dimer, ATIII, TF, TFPI and CRP were assessed. TF and TFPI levels were measured in the control group of forty healthy individuals without SCI, the rest of the parameters were compared to laboratory norms.

Results: D-dimer levels were significantly higher in group I compared to group II (P = .0002) and group III (P < .001). Group II had higher D-dimer levels than group III (P = .032). TFPI levels were higher in group II compared with group III (P = .0041) and control group (P = .000033). TF was significantly higher in all the SCI groups compared with the control group (P < .001).

Conclusions: D-dimer and TF levels were still elevated twelve months after SCI. TF levels were also elevated over 12 months after inury. The results may indicate that sub-acute and even chronic SCI patients have disturbed coagulation and fibrynolitic system.



中文翻译:

脊髓损伤亚急性期和慢性期康复患者的止血参数

目的:本研究的目的是测量 SCI 后的止血标志物。

设计:横断面研究评估 SCI 患者在受伤后不同时间的凝血和原纤维蛋白系统的变化。

环境: 2011 年至 2017 年,波兰比得哥什大学医院康复科。

参与者:急性和慢性康复期间的 SCI 患者 ( N  = 88)。

结果测量:评估以下参数:血小板计数和 D-二聚体、抗凝血酶 III (ATIII)、组织因子 (TF)、组织因子通路抑制剂 (TFPI) 和炎症标志物 C 反应蛋白 (CRP) 的水平。

干预措施: 88 名 SCI 患者根据受伤时间分为三组:I 组(三周至三个月)、II 组(三至十二个月)和 III 组(超过十二个月)。所有患者都接受了超声检查 (US) 以检测急性或慢性再通深静脉血栓形成 (DVT)。评估了血小板计数和 D-二聚体、ATIII、TF、TFPI 和 CRP 的水平。在没有 SCI 的 40 名健康个体的对照组中测量 TF 和 TFPI 水平,其余参数与实验室规范进行比较。

结果:与组 II (P = .0002) 和组 III (P < .001) 相比,I 组的 D-二聚体水平显着更高。第二组的 D-二聚体水平高于第三组(P = .032)。与组 III (P = .0041) 和对照组 (P = .000033) 相比,组 II 的 TFPI 水平更高。与对照组相比,所有 SCI 组的 TF 均显着升高(P < .001)。

结论: SCI 后 12 个月 D-二聚体和 TF 水平仍然升高。受伤后 12 个月内 TF 水平也升高。结果可能表明亚急性甚至慢性 SCI 患者的凝血和纤溶系统受到干扰。

更新日期:2020-02-03
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