title: Alterations of the preoperative coagulation profile in patients with acute appendicitis.
abstract: BACKGROUND
  Acute appendicitis (AA) is usually associated with a systemic inflammatory response that often leads to activation of coagulation. However, limited data about coagulation changes in AA are available.
  
  
  METHODS
  Results of preoperative coagulation testing in 702 patients with confirmed AA and 697 patients undergoing minor elective surgery (control) during the same period were analyzed retrospectively. Coagulation activity of factors VII, IX (FVII:C, FIX:C) and the concentration of plasma endotoxin from 40 patients with AA and 15 control subjects were measured.
  
  
  RESULTS
  Compared with control subjects, prothrombin time (PT), fibrinogen (Fib) and endotoxin increased (all p<0.01), FVII:C decreased (p<0.05), and thrombin time shortened (p<0.01) significantly in patients with AA, which showed trends with increasing severity of disease. Areas under the receiver operating characteristic curve of Fib for discriminating complicated appendicitis or acute perforated appendicitis from enrolled patients were larger than those for leukocyte parameters. The concentration of endotoxin correlated negatively with FVII:C (r=-0.860, p<0.001), positively with PT (0.713, <0.001), and FVII:C negatively with PT (-0.729, <0.001) in individuals that were evaluated. The change in activated partial thromboplastin time and difference in FIX:C among patients with various pathological types of appendicitis were not significant.
  
  
  CONCLUSIONS
  Endotoxin-induced activation of the extrinsic coagulation pathway was present in patients with AA. Fib may be useful as a potential indicator for excluding complicated appendicitis.
authors.affiliation: Department of Laboratory Medicine, Peking University Shenzhen Hospital, Shenzhen, P.R. China.
authors.forename: Jianxin
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Patients' Archive Management and Statistics, Peking University Shenzhen Hospital, Shenzhen, P.R. China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Liu
authors.affiliation: Department of Pathology, Peking University Shenzhen Hospital, Shenzhen, P.R. China.
authors.forename: Weihua
authors.initials: W
authors.lastname: Yin
authors.affiliation: Department of Laboratory Medicine, Peking University Shenzhen Hospital, Shenzhen, P.R. China.
authors.forename: Chuanzhou
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Laboratory Medicine, Peking University Shenzhen Hospital, Shenzhen, P.R. China.
authors.forename: Jinhe
authors.initials: J
authors.lastname: Huang
authors.affiliation: Department of Laboratory Medicine, Peking University Shenzhen Hospital, Shenzhen, P.R. China.
authors.forename: Chaoyu
authors.initials: C
authors.lastname: Liao
authors.affiliation: Department of Laboratory Medicine, Peking University Shenzhen Hospital, Shenzhen, P.R. China.
authors.forename: Liping
authors.initials: L
authors.lastname: Nie
authors.affiliation: Department of Laboratory Medicine, Peking University Shenzhen Hospital, Shenzhen, P.R. China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Department of General Surgery, Peking University Shenzhen Hospital, Shenzhen, P.R. China.
authors.forename: Ping
authors.initials: P
authors.lastname: Xiao
mesh_terms: D000208:Acute Disease; D000328:Adult; D001064:Appendicitis / Q000097:blood* / Q000150:complications; D019540:Area Under Curve; D016470:Bacteremia / Q000150:complications; D001780:Blood Coagulation Tests; D004731:Endotoxins / Q000097:blood; D005167:Factor VII / Q000378:metabolism; D005170:Factor X / Q000378:metabolism; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D011517:Prothrombin Time; D012189:Retrospective Studies
chemical_list: D004731:Endotoxins; D005167:Factor VII; D005170:Factor X; D005340:Fibrinogen