Prevalence of platelet dysfunction and abnormal coagulation: results of a population-based study

Clin Appl Thromb Hemost. 2009 Jul-Aug;15(4):421-7. doi: 10.1177/1076029608315164. Epub 2008 Apr 2.

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.

MeSH terms

  • Acute Disease / epidemiology
  • Adult
  • Anticoagulants / therapeutic use
  • Aspirin
  • Blood Coagulation Disorders / chemically induced
  • Blood Coagulation Disorders / diagnosis*
  • Blood Coagulation Disorders / epidemiology*
  • Blood Coagulation Tests
  • Blood Platelet Disorders / chemically induced
  • Blood Platelet Disorders / diagnosis*
  • Blood Platelet Disorders / epidemiology*
  • Emergency Service, Hospital / statistics & numerical data*
  • Hemorrhage / epidemiology
  • Humans
  • Mass Screening / methods
  • Platelet Aggregation Inhibitors
  • Platelet Function Tests
  • Prevalence
  • Surveys and Questionnaires

Substances

  • Anticoagulants
  • Platelet Aggregation Inhibitors
  • Aspirin