Publication: he use of clot waveform analysis as an additional parameter for venous thromboembolism risk assessment in patient with prolonged immobilization
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Date
2022
Authors
Yusoff, Rosmaniza Muhamat
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Abstract
Objectives: Prolonged immobilization is a well-known risk factor for thromboembolism. This study aims to compare the clot waveform analysis (CWA) parameters between patients with prolonged immobilization and normal controls. We also intended to compare patients’ clot waveform parameters at day one and after day three of immobilization. Methods: A total of 30 patients with prolonged immobilization from Hospital USM were recruited for this study. The patients’ plasma were taken on day one of admission and were repeated after a period of immobilization (on day three and above). The coagulation profile (prothrombin time, PT and activated partial thromboplastin time, aPTT) was performed using ACL TOP 300 CTS (Bedford,USA) coagulation analyser that utilize optical method for clot detection. Blood sample for 20 normal controls were recruited from healthy blood donors. The clot waveform for PT and aPTT generated during clot formation was then analysed. For comparison of clot waveform analysis between healthy controls and patients with prolonged immobilization, Mann-Whitney test was used. Paired t-test was used for the comparison of clot wave parameters between day one of immobilization and day three and above. This study was approved by Universiti Sains Malaysia Research Ethics Committee (JEPeM code: USM/JEPeM/20010032). Result: Mean PT and aPTT for healthy controls were 11.66 seconds and 33.98 seconds, respectively. There was no significant difference in mean PT and aPTT between patients and controls. However, the mean PT CWA parameters were significantly higher among time velocity and height velocity. While for aPTT CWA, the delta change and height velocity were significantly higher than controls. PT CWA parameters among patient with prolonged immobilization showed no significant difference between day one and day three of immobilization, while for aPTT CWA, all parameters were higher after day three of immobilization except for time of endpoint. Conclusion: Patients with prolonged immobilization had elevated PT and aPTT CWA parameters compared to normal controls. CWA parameters may help to recognize patient at risk of developing thrombosis through the changes at the clot waveform. However, we need more study on the clot waveform so that additional information from routine coagulation testing can be fully utilize.
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