PDF(Pubmed)
Abstract：
UNASSIGNED: Severe yellow fever infection (YFI) may be complicated by a hemorrhagic diathesis. However, the hemostasis profile of YFI has rarely been reported.
UNASSIGNED: The aim of this study was to characterize the hemostatic features of YFI by using a rotational thromboelastometry (ROTEM).
UNASSIGNED: We evaluated clinical, laboratory, and ROTEM parameters in adults with severe YFI and their correlation with hemostatic variables according to bleeding and death.
UNASSIGNED: A total of 35 patients were included (median age, 49 years). ROTEM was performed in 22 patients, of whom 21 (96%) presented bleeding and 4 (18%) died. All patients who died had major bleeding. Patients who died presented prolonged clotting time (CT; median, 2326 seconds; IQR, 1898-2986 seconds) and reduced alpha angle (median, 12°; IQR, 12°-15°) in comparison with patients who had minor (median CT, 644 seconds; IQR, 552-845 seconds and alpha angle, 47°; IQR, 28°-65°) and major (median CT, 719 seconds; IQR, 368-1114 seconds and alpha angle, 43°; IQR, 32°-64°) bleeding who survived. In patients who had bleeding, CT showed a strong negative correlation with factor (F)V (r = -.68), FIX (r = -.84), and FX (r = -.63) as well as alpha angle showed a strong negative correlation with FIX (r = -.92). In patients who died, the correlations were even stronger. A total of 19/21 (90%) patients presented hypocoagulability assessed by ROTEM.
UNASSIGNED: Hypocoagulabitity is the hallmark of the bleeding diathesis of severe YFI. Abnormal CT and alpha angle associated with death and could be used as potential predictors of adverse outcome in severe YFI.
UNASSIGNED: The aim of this study was to characterize the hemostatic features of YFI by using a rotational thromboelastometry (ROTEM).
UNASSIGNED: We evaluated clinical, laboratory, and ROTEM parameters in adults with severe YFI and their correlation with hemostatic variables according to bleeding and death.
UNASSIGNED: A total of 35 patients were included (median age, 49 years). ROTEM was performed in 22 patients, of whom 21 (96%) presented bleeding and 4 (18%) died. All patients who died had major bleeding. Patients who died presented prolonged clotting time (CT; median, 2326 seconds; IQR, 1898-2986 seconds) and reduced alpha angle (median, 12°; IQR, 12°-15°) in comparison with patients who had minor (median CT, 644 seconds; IQR, 552-845 seconds and alpha angle, 47°; IQR, 28°-65°) and major (median CT, 719 seconds; IQR, 368-1114 seconds and alpha angle, 43°; IQR, 32°-64°) bleeding who survived. In patients who had bleeding, CT showed a strong negative correlation with factor (F)V (r = -.68), FIX (r = -.84), and FX (r = -.63) as well as alpha angle showed a strong negative correlation with FIX (r = -.92). In patients who died, the correlations were even stronger. A total of 19/21 (90%) patients presented hypocoagulability assessed by ROTEM.
UNASSIGNED: Hypocoagulabitity is the hallmark of the bleeding diathesis of severe YFI. Abnormal CT and alpha angle associated with death and could be used as potential predictors of adverse outcome in severe YFI.
摘要：
■严重的黄热病感染（YFI）可能会并发出血性素质。然而,YFI的止血概况鲜有报道.
■本研究的目的是通过使用旋转血栓弹性测定法（ROTEM）来表征YFI的止血特征。
■我们评估了临床，实验室,重度YFI成人的ROTEM参数及其与出血和死亡的止血变量的相关性。
■共纳入35例患者（中位年龄，49年）。对22例患者进行了ROTEM，其中21人(96%)出现出血,4人(18%)死亡.所有死亡的患者均有大出血。死亡的患者凝血时间延长（CT；中位数，2326秒；IQR，1898-2986秒）和减小的α角（中位数，12°;IQR,12°-15°)与轻度患者(中位CT，644秒；IQR，552-845秒和α角，47°;IQR,28°-65°)和主要(中位CT，719秒；IQR，368-1114秒和α角,43°;IQR,32°-64°）存活的出血。在出血的病人中，CT显示与因子（F）V呈强负相关（r=-.68），FIX（r=-.84），和FX（r=-.63）以及α角与FIX（r=-.92）呈强负相关。在死亡的病人中，相关性甚至更强。通过ROTEM评估，共有19/21（90％）患者表现出低凝状态。
■低凝性是严重YFI出血素质的标志。异常CT和α角与死亡相关，可用作严重YFI不良结局的潜在预测因子。
■本研究的目的是通过使用旋转血栓弹性测定法（ROTEM）来表征YFI的止血特征。
■我们评估了临床，实验室,重度YFI成人的ROTEM参数及其与出血和死亡的止血变量的相关性。
■共纳入35例患者（中位年龄，49年）。对22例患者进行了ROTEM，其中21人(96%)出现出血,4人(18%)死亡.所有死亡的患者均有大出血。死亡的患者凝血时间延长（CT；中位数，2326秒；IQR，1898-2986秒）和减小的α角（中位数，12°;IQR,12°-15°)与轻度患者(中位CT，644秒；IQR，552-845秒和α角，47°;IQR,28°-65°)和主要(中位CT，719秒；IQR，368-1114秒和α角,43°;IQR,32°-64°）存活的出血。在出血的病人中，CT显示与因子（F）V呈强负相关（r=-.68），FIX（r=-.84），和FX（r=-.63）以及α角与FIX（r=-.92）呈强负相关。在死亡的病人中，相关性甚至更强。通过ROTEM评估，共有19/21（90％）患者表现出低凝状态。
■低凝性是严重YFI出血素质的标志。异常CT和α角与死亡相关，可用作严重YFI不良结局的潜在预测因子。
