Utility of rotational thrombo-elastometry as an objective measure of hypercoagulability in ulcerative colitis.

IF 2 Q3 GASTROENTEROLOGY & HEPATOLOGY

Indian Journal of Gastroenterology Pub Date : 2025-04-26 DOI:10.1007/s12664-025-01759-7

P Krishna Bharadwaj, Ebby George Simon, Rutvi G Dave, Tulasi Geevar, Sukesh C Nair, Joseph Aj, Amit Kumar Dutta, Rajeeb Jaleel, Anoop John, Ajith Thomas, Amith Viswanath

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Abstract

Background and aims: Inflammatory bowel disease (IBD) has an increased risk of venous thromboembolism (VTE), with factors such as hospitalization and surgery enhancing this risk. This study was aimed at evaluating rotational thrombo-elastometry (ROTEM) for assessing blood coagulation status in ulcerative colitis (UC) and determining its relationship with disease severity and response to treatment.

Methods: This was a prospective age and sex-matched study with 60 patients each in UC and irritable bowel syndrome groups, the latter being controls. Clinical details and blood investigations, including ROTEM (clotting time [CT], clot formation time [CFT], alpha angle [AA], maximum clot firmness [MCF], maximum lysis [ML]) and D-dimer, were collected, analyzed and compared between the two groups. A hypercoagulable state was defined by Kaufmann et al. as having two or more of the following: short CT and/or CFT time, increased AA and increased MA.

Results: There were 60 patients with UC (age, 38.6 ± 11.64 years; 44 males). The UC group significantly had more patients with hypercoagulable ROTEM than the control group (66.7% vs. 36.7%, p = 0.001). In UC patients with hypercoagulable ROTEM, nine patients were in remission and 31 patients had active disease. Compared to controls, CT, CFT, AA, MCF and D-dimer levels were significantly abnormal in the UC group. Among UC patients with increasing severity, only CFT, AA and D-dimer differed significantly across the groups. There were no significant differences in ROTEM values and D-dimer in patients with severe UC at admission compared to one-week post-discharge. Only hemoglobin (OR, 0.61; 95% CI, 0.38-0.98; p = 0.04) was found to be a significant independent predictor of a hypercoagulable state of active UC, on multivariate analysis.

Conclusions: More patients with UC had hypercoagulable ROTEM compared to controls, which increased with disease severity. Low hemoglobin was predictive of a hypercoagulable state in active UC.

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旋转血栓弹性测量法作为溃疡性结肠炎高凝性客观测量的应用。

背景和目的：炎症性肠病（IBD）发生静脉血栓栓塞（VTE）的风险增加，住院和手术等因素会增加这种风险。本研究旨在评估旋转血栓弹性测量法（ROTEM）用于评估溃疡性结肠炎（UC）患者的凝血状态，并确定其与疾病严重程度和治疗反应的关系。方法：这是一项年龄和性别匹配的前瞻性研究，UC组和肠易激综合征组各60例患者，后者为对照组。收集两组患者的临床资料及血液检查指标ROTEM（凝血时间[CT]、凝块形成时间[CFT]、α角[AA]、最大凝块硬度[MCF]、最大溶解度[ML]）、d -二聚体进行分析比较。Kaufmann等人将高凝状态定义为具有以下两种或两种以上特征：CT和/或CFT时间短，AA和MA升高。结果：60例UC患者(年龄：38.6±11.64岁；44岁男性)。UC组高凝性ROTEM患者明显多于对照组（66.7% vs. 36.7%, p = 0.001）。UC合并高凝性ROTEM患者中，9例患者病情缓解，31例患者病情活跃。与对照组相比，UC组CT、CFT、AA、MCF、d -二聚体水平均明显异常。在严重程度增加的UC患者中，只有CFT、AA和d -二聚体在组间存在显著差异。与出院后一周相比，入院时严重UC患者的ROTEM值和d -二聚体无显著差异。只有血红蛋白(OR, 0.61；95% ci, 0.38-0.98；p = 0.04)在多变量分析中被发现是活动性UC高凝状态的重要独立预测因子。结论：与对照组相比，更多UC患者有高凝性ROTEM，且随疾病严重程度增加。低血红蛋白预示着活动性UC的高凝状态。

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来源期刊

Indian Journal of Gastroenterology GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

3.90

自引率

10.00%

发文量

期刊介绍： The Indian Journal of Gastroenterology aims to help doctors everywhere practise better medicine and to influence the debate on gastroenterology. To achieve these aims, we publish original scientific studies, state-of -the-art special articles, reports and papers commenting on the clinical, scientific and public health factors affecting aspects of gastroenterology. We shall be delighted to receive articles for publication in all of these categories and letters commenting on the contents of the Journal or on issues of interest to our readers.