Department of Surgery, Division of Minimally Invasive and Elective General Surgery, McGovern Medical School, University of Texas Health Science Center at Houston, 6431 Fannin Street, MSB 4.156, Houston, TX, 77030, USA.
Department of Internal Medicine, Division of Clinical and Translational Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA.
Obes Surg. 2021 Aug;31(8):3590-3597. doi: 10.1007/s11695-021-05445-3. Epub 2021 Apr 30.
INTRODUCTION/PURPOSE: Some clinical indicators suggest hypercoagulability/hyperaggregability in patients with morbid obesity. Thromboelastography (TEG®) has been used to profile coagulation status in surgical patients. We aimed to assess coagulation profiles in patients with morbid obesity undergoing bariatric surgery by correlating demographic and patient characteristics to pre-operative TEG® values.
Pre-operative TEG® values from 422 patients undergoing bariatric surgery were evaluated. TEG® results were analyzed by gender, use of medications known to alter the coagulation profile, and body mass index (BMI).
Patients have a mean of 45.03 ± 11.8 years, female (76.3%), and with a mean BMI of 42 kg/m . The overall coagulation profile of female patients was significantly different from males, even in the sub-cohort without use of medications known to alter coagulation. The majority of patients (94%) with a G value > 15 dynes/cm (clot strength) were female. In females, there was no association between BMI and TEG® values; however, in men, there was a statistically significant difference in TEG® values for those with BMI < 40 kg/m compared to those with BMI > 50 kg/m.
TEG®-based analysis of coagulation profiles offers unique insights. Compared to laboratory normal values (R time, angle, maximal amplitude, and G values), patients with morbid obesity may have a tendency for hypercoagulability/hyperaggregability, with mean values at the higher limit. A significant hypercoagulable difference in TEG® values was identified in female as compared to male patients. Male patients with a BMI greater than 50 kg/m were also found to be increasingly hypercoagulable.
简介/目的：一些临床指标表明病态肥胖患者存在高凝/高聚集状态。血栓弹力图（TEG®）已用于手术患者的凝血状态分析。我们旨在通过将人口统计学和患者特征与术前 TEG®值相关联，评估病态肥胖患者行减重手术后的凝血谱。
评估了 422 例行减重手术患者的术前 TEG®值。通过性别、使用已知改变凝血谱的药物以及体重指数（BMI）对 TEG®结果进行分析。
患者平均年龄为 45.03 ± 11.8 岁，女性（76.3%），平均 BMI 为 42 kg/m²。女性患者的整体凝血谱与男性明显不同，即使在不使用已知改变凝血的药物的亚组中也是如此。大多数（94%）G 值>15 达因/cm²（凝块强度）的患者为女性。在女性中，BMI 与 TEG®值之间没有关联；然而，在男性中，BMI<40 kg/m²与 BMI>50 kg/m²的患者之间，TEG®值存在统计学差异。
基于 TEG®的凝血谱分析提供了独特的见解。与实验室正常值（R 时间、角度、最大振幅和 G 值）相比，病态肥胖患者可能存在高凝/高聚集倾向，平均值处于较高水平。与男性患者相比，女性患者的 TEG®值存在明显的高凝差异。还发现 BMI 大于 50 kg/m²的男性患者的凝血状态也逐渐变得更为亢进。
