评估因原发性肝肿瘤接受肝叶切除术的犬的术前凝血功能:多机构回顾性研究。

IF 1.3 2区 农林科学 Q2 VETERINARY SCIENCES Veterinary Surgery Pub Date : 2024-10-01 Epub Date: 2024-08-16 DOI:10.1111/vsu.14155
Samuel J Burkhardt, Kenneth L Drobatz, Beth Callan, William T N Culp, Laura E Selmic, Karen Tobias, Mandy L Wallace, Deanna Worley, David E Holt
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引用次数: 0

摘要

研究背景本研究的目的是(i)确定可手术的原发性肝肿瘤是否与凝血酶原时间(PT)和活化部分凝血活酶时间(aPTT)延长有关;(ii)确定这些继发性止血异常是否在特定肝肿瘤中更为普遍:多机构回顾性研究:动物群体:因原发性肝肿瘤而接受肝叶切除术的犬(n = 359),并进行术前凝血功能检查:方法:通过八家兽医教学医院的电子病历审查确定数据。从病历中提取犬的基线特征、凝血功能检查值、血小板计数、急诊与非急诊手术、是否输血、切除的肝叶以及组织病理学诊断。采用卡方分析比较组间的分类变量。连续变量采用 Shapiro-Wilk 检验进行正态性评估:在 359 只狗中,共有 74 只(20.6%)在术前出现 PT 或 aPTT 延长。在 359 只狗中,共有 20 只(5.6%)的 PT 和 aPTT 同时延长。血管肉瘤是唯一与 PT 和 aPTT 同时延长相关的组织病理学诊断(P包括 PT 和 aPTT 在内的凝血功能检查不太可能检测出大多数原发性肝肿瘤患犬的继发性止血功能缺陷,组织病理学诊断为血管肉瘤的患犬除外:PT和aPTT检测作为原发性肝肿瘤患犬的术前选择性筛查检测,除了有血腹或高度怀疑肝血管肉瘤的患犬外,收益率很低。
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Evaluating preoperative coagulation panels in dogs undergoing liver lobectomy for primary liver tumors: A multi-institutional retrospective study.

Background: The objectives of this study were to: (i) Determine whether operable primary liver tumors were associated with prolongations in prothrombin time (PT) and activated partial thromboplastin time (aPTT) and (ii) determine if these secondary hemostatic abnormalities were more prevalent with specific liver tumors.

Study design: Multi-institutional retrospective study.

Animal population: Dogs (n = 359) undergoing liver lobectomy for a primary liver tumor with a preoperative coagulation panel.

Methods: Data was identified via electronic medical record review at eight veterinary teaching hospitals. Baseline dog characteristics, coagulation panel values, platelet count, emergency versus non-emergency procedure, whether the dogs received transfusion(s) of a blood product, liver lobe removed, and histopathological diagnosis were extracted from the medical record. Chi-square analysis was used to compare categorical variables between groups. Continuous variables were assessed for normality using the Shapiro-Wilk test.

Results: A total of 74 of 359 dogs (20.6%) had a prolongation in either PT or aPTT preoperatively. A total of 20 of 359 dogs (5.6%) were found to have prolongation of both PT and aPTT. Hemangiosarcoma was the only histopathological diagnosis associated with concurrent prolongations of both PT and aPTT (p < .001) in 6/16 (37.5%) dogs.

Conclusion: Coagulation panels including PT and aPTT are unlikely to detect substantial deficiencies in secondary hemostasis in most dogs with primary liver tumors except in dogs with a histopathological diagnosis of hemangiosarcoma.

Clinical significance: PT and aPTT testing is low yield as an elective preoperative screening test in dogs with primary liver tumors except in dogs where there is a hemoabdomen or high suspicion for hepatic hemangiosarcoma.

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来源期刊
Veterinary Surgery
Veterinary Surgery 农林科学-兽医学
CiteScore
3.40
自引率
22.20%
发文量
162
审稿时长
8-16 weeks
期刊介绍: Veterinary Surgery, the official publication of the American College of Veterinary Surgeons and European College of Veterinary Surgeons, is a source of up-to-date coverage of surgical and anesthetic management of animals, addressing significant problems in veterinary surgery with relevant case histories and observations. It contains original, peer-reviewed articles that cover developments in veterinary surgery, and presents the most current review of the field, with timely articles on surgical techniques, diagnostic aims, care of infections, and advances in knowledge of metabolism as it affects the surgical patient. The journal places new developments in perspective, encompassing new concepts and peer commentary to help better understand and evaluate the surgical patient.
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