title: Prevalence of platelet dysfunction and abnormal coagulation: results of a population-based study.
abstract: The prevalence of impairments in the hemostatic process is unknown in acutely ill people. Data on hemostasis (PFA 100) and the coagulation cascade of 1015 people are presented here, establishing a cohort of unselected emergency patients in a population-based approach. A high prevalence of reduced platelet function (38%) was found, which was more frequent than expected. In contrast, there was a lower prevalence (20%) of abnormal plasmatic coagulation, which was almost always explained by medication, whereas medication could not predict abnormal platelet function. Moreover, a history of disproportionate bleeding did not correlate well with abnormal platelet or coagulation factor function and could not substitute for a screening in this setting. The effect of acetylsalicylic acid (ASA) on PFA-closure time was frequently missing (34%), indicating a considerable prevalence of ASA nonresponse among the study population. These data should be applicable in similar settings. The high prevalence of unexpectedly abnormal platelet function in acute illness as well as the high prevalence of possible ASA nonresponders suggests a functional platelet assay to be effective in screening certain subpopulations of emergency patients.
authors.affiliation: Department of Medicine I, Hematology, University Hospital Schleswig-Holstein, Ratzeburger Allee 160, Lübeck, Germany. janmarxsen@web.de
authors.forename: Jan H
authors.initials: JH
authors.lastname: Marxsen
authors.forename: Sonja
authors.initials: S
authors.lastname: Forchheim
authors.forename: Alexandra
authors.initials: A
authors.lastname: Zuske-Matthäus
authors.forename: Thomas
authors.initials: T
authors.lastname: Wagner
mesh_terms: D000208:Acute Disease / Q000453:epidemiology; D000328:Adult; D000925:Anticoagulants / Q000627:therapeutic use; D001241:Aspirin; D001778:Blood Coagulation Disorders / Q000139:chemically induced / Q000175:diagnosis* / Q000453:epidemiology*; D001780:Blood Coagulation Tests; D001791:Blood Platelet Disorders / Q000139:chemically induced / Q000175:diagnosis* / Q000453:epidemiology*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D006470:Hemorrhage / Q000453:epidemiology; D006801:Humans; D008403:Mass Screening / Q000379:methods; D010975:Platelet Aggregation Inhibitors; D010979:Platelet Function Tests; D015995:Prevalence; D011795:Surveys and Questionnaires
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin