Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis
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Blood Coagul. Fibrinolysis · Jun 2014
Comparative StudyComparison of five D-dimer reagents and application of an age-adjusted cut-off for the diagnosis of venous thromboembolism in emergency department.
There is still a considerable uncertainty concerning D-dimer cut-off values used in exclusion of venous thromboembolic (venous thromboembolism, VTE) disease, especially among the elderly patients. The objectives were to compare five different D-dimer reagents in the daily practice of an emergency department and to test retrospectively the performances of an age-adjusted cut-off. A total of 473 consecutive ambulatory outpatients suspected of VTE (confirmed VTE = 21) were included in this study. ⋯ The interest of such strategy is more or less pronounced, depending on the type of D-dimer reagent. The application of an age-adjusted cut-off may be useful to reduce differences among D-dimer reagents to lower costly imaging studies. Prospective validation studies on large cohorts of patients are required to determine the safety of such strategy.
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Blood Coagul. Fibrinolysis · Jun 2014
Case ReportsThe effect of recombinant human soluble thrombomodulin on disseminated intravascular coagulation in an abdominal aortic aneurysm.
Aortic aneurysms are sometimes accompanied with disseminated intravascular coagulation (DIC). The definitive treatment of DIC is removal of underlying disease; surgical repair for the aortic aneurysms. ⋯ After having confirmed that combined use of heparin and gabexate mesilate was ineffective, we used recombinant human soluble thrombomodulin (rhsTM), which has been reported to be more effective and safer than the heparin, for a week preoperatively, and demonstrated dramatic improvement of DIC. RhsTM should be a novel powerful therapeutic option for aneurysm-induced DIC.
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Blood Coagul. Fibrinolysis · Jun 2014
The influence of coagulopathy on outcome after traumatic subdural hematoma: a retrospective single-center analysis of 319 patients.
The aim of this study was to identify the effects of coagulopathy on the outcome of patients with traumatic subdural hematoma (SDH). Based on a retrospective study, the records of all patients admitted between 2001 and 2007 to a large emergency hospital with acute SDH resulting from traumatic brain injury (TBI) were analyzed. An initial Glasgow coma score (GCS), clinical state, and Glasgow outcome score (GOS) were recorded for all patients. ⋯ Patients with coagulopathy had a significantly worse outcome. Almost twice as many patients died in the coagulopathy group (mean GOS 3.10 ± 1.46) than in the group without coagulopathy (mean GOS 2.16 ± 1.45), (P < 0.001). In-hospital mortality is twice as frequent in patients with coagulopathy with traumatic SDH compared with noncoagulopathic patients, even if the initial severity of the TBI does not differ.