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   influence of factor xii deficiency on activated partial thromboplastin time (aptt) in critically ill patients  
   
نویسنده bachler mirjam ,niederwanger christian ,hell tobias ,höfer judith ,gerstmeyr dominic ,schenk bettina ,treml benedikt ,fries dietmar
منبع journal of thrombosis and thrombolysis - 2019 - دوره : 48 - شماره : 3 - صفحه:466 -474
چکیده    Fxii deficiency results in spontaneous prolongation of activated partial thromboplastin time (aptt), which is widely used to monitor thromboprophylaxis. misinterpretation of spontaneously prolonged aptt result in omission of thromboembolic treatment or even unnecessary transfusion of blood products. this retrospective analysis was performed to calculate a threshold level of fxii resulting in aptt prolongation. 79 critically ill patients with spontaneous prolongation of aptt were included. a correlation analysis and a roc curve for aptt prolongation predicted by fxii level were created to find the fxii threshold level. prolongation of aptt was associated with disease severity. a significant inverse proportionality between fxii and aptt was seen. a roc curve for aptt prolongation, predicted by fxii level (auc 0.85; ci 0.76–0.93), revealed a fxii threshold level of 42.5%. of our patients 50.6% experienced a fxii deficiency, in 80.0% of whom we found aptt to be prolonged without a significantly higher bleeding rate. the fxii deficiency was more common in patients with higher saps3 scores, septic shock, transfusion of red blood cells and platelet concentrates as well as in patients receiving renal replacement therapy. patients with a fxii deficiency and prolonged aptt less often received anticoagulatory therapy although they were more severely ill. the rate of thromboembolic events was higher in these patients although the difference was not statistically significant. of all patients with spontaneous aptt prolongation 50.6% had a fxii level of 42.5% or less. those patients received insufficient thromboembolic prophylaxis.
کلیدواژه anticoagulation ,fxii deficiency ,aptt ,critically ill patients ,thromboprophylaxis
آدرس umit - university for health sciences, institute for sports medicine, eduard wallnöfer zentrum 1, austria, medical university of innsbruck, department of pediatrics, pediatric intensive care unit, austria, university of innsbruck, faculty of mathematics, department of mathematics, austria, academic teaching hospital of the paracelsus medical university, auva trauma centre salzburg, department of anesthesiology and intensive care medicine, austria, medical university innsbruck, department of general and surgical critical care medicine, austria, medical university innsbruck, department of general and surgical critical care medicine, austria, medical university innsbruck, department of general and surgical critical care medicine, austria, medical university innsbruck, department of general and surgical critical care medicine, austria
 
     
   
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