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Published in: Obesity Surgery 8/2017

01-08-2017 | Original Contributions

Thrombin Generation Measurements in Patients Scheduled for Laparoscopic Bariatric Surgery

Authors: Jérémie Thereaux, Fanny Mingant, Charles Roche, Hubert Galinat, Francis Couturaud, Karine Lacut

Published in: Obesity Surgery | Issue 8/2017

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Abstract

Purpose

Obese patients are known to be in an in vitro hypercoagulable state relative to normal-weight patients. Our study aimed to identify markers of enhanced coagulability (endogenous thrombin potential (ETP)) in morbidly obese patients using the thrombin generation (TG) test.

Materials and Methods

All patients scheduled for laparoscopic bariatric surgery (LBS) between September 1, 2014 and January 31, 2016 were eligible for our prospective study. We used logistic regression to compute the odds ratio (OR) across ETP quartile distributions to evaluate the risk of enhanced TG.

Results

We studied 102 patients, 77.5% were female, mean age was 41.2 ± 12.1 years, and mean BMI was 45.5 ± 7.0 k/m2. Total cholesterol and fibrinogen levels were found to be independent risk factors for patients in the 4th quartile distribution of the ETP distribution (OR (95% CI)) 2.6 (1.2 to 5.4) (P = 0.01) and 2.2 (1.1 to 4.5 (P = 0.03). Patients in the 4th quartile of the ETP distribution had a lower ETP 1 month after surgery (157 (144–196) vs. 120 (98–140); P < 0.001) in parallel with a trend toward lower total cholesterol levels (5.0 ± 0.9 vs. 4.4 ± 1.0; P = 0.06). Fibrinogen levels were stable (4.5 ± 1.0 vs. 4.4 ± 0.9); P = 0.7).

Conclusions

Our study highlights the role of total cholesterol and blood inflammatory marker levels in enhancing ETP in morbidly obese patients. Further studies are necessary to confirm the decreased ETP following LBS with the expected reduced inflammatory marker and total cholesterol levels.
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Metadata
Title
Thrombin Generation Measurements in Patients Scheduled for Laparoscopic Bariatric Surgery
Authors
Jérémie Thereaux
Fanny Mingant
Charles Roche
Hubert Galinat
Francis Couturaud
Karine Lacut
Publication date
01-08-2017
Publisher
Springer US
Published in
Obesity Surgery / Issue 8/2017
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-017-2545-5

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