• Jennifer M Watters, Chitra N Sambasivan, Karen Zink, Igor Kremenevskiy, Michael S Englehart, Samantha J Underwood, and Martin A Schreiber.
• Department of Surgery, Division of Trauma, Critical Care and Acute Care Surgery, Oregon Health and Science University, Portland, OR, USA. wattersj@ohsu.edu
• Am. J. Surg. 2010 May 1;199(5):646-51.

BackgroundIt was hypothesized that splenectomy following trauma results in hypercoagulability.MethodsA prospective, nonrandomized, single-center study was performed to evaluate coagulation parameters in trauma patients with splenic injury.ResultsPatients 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).ConclusionsA significant difference in deep venous thrombosis formation was noted, and coagulation assays indicated persistent hypercoagulability following splenectomy for trauma.Copyright 2010 Elsevier Inc. All rights reserved.

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