Assessing thrombosis risk in patients with idiopathic, diabetic, and postsurgical gastroparesis

Amy Lobrano, Kevin Blanchard, William Rock, William Johnson, Bob Schmieg, Karen Borman, Farshid Araghizadeh, Anil Minocha, Thomas L. Abell

Research output: Contribution to journalArticle

3 Scopus citations

Abstract

Patients with severe gastrointestinal motility disorders are often found to have intravenous access clots or deep venous thrombosis. It has previously been report-ed that many patients who have intravenous access thrombosis have concomitant thrombotic risk factors. In this study, the goal was to determine the underlying prevalence of hypercoagulable risk in a series of patients with documented gastroparesis. Investigators studied 62 consecutive patients (52 female; mean age, 42 y) who had symptoms of gastroparesis. All patients were evaluated for placement of a gastric neural stimulation device, or they had had one placed previously. Patients underwent a hematologic interview and standardized coagulation measures of thrombotic risk. Laboratory studies measured acquired elevations of Factor VII, Factor VIII, fibrinogen, lupus anticoagulant panel, antiphospholipid antibody panel, homocysteine (in the setting of kidney disease), and activated protein resistance. Investigators also measured congenital factors: Factor VIII (with C-reactive protein levels), antithrombin III, protein C, protein S (total and free), Factor II mutation, Factor V Leiden, methylenetetrahydrofolate reductase, and homocysteine. Fifty-five patients (89%) were found to have detectable hypercoagulable risk factors. Twenty-five of the 62 patients (40%) had a documented history of abnormal clotting, including deep venous thrombosis, intravenous access thrombosis, and pulmonary embolism. All patients with a previous history of thrombosis had detectable clotting abnormalities. Of 56 patients, 40 (71%) had hypercoagulability and did not have diabetes (P=.036), and 20 (36%) had hypercoagulability and no known history of infection. However, this value was not statistically significant when infection and hypercoagulability were compared (P=.408). A high prevalence of acquired and congenital hypercoagulable defects has been observed in patients with gastroparesis, which may predispose them to arterial and venous clots. This unique finding warrants consideration of coagulation evaluation in patients with severe gastroparesis, especially when these patients are placed in high-risk thrombophilic situations, such as hospitalization, prolonged intravenous access, and surgery.

Original languageEnglish (US)
Pages (from-to)750-768
Number of pages19
JournalAdvances in Therapy
Volume23
Issue number5
DOIs
StatePublished - Jan 1 2006

Keywords

  • Coagulation
  • Gastroparesis
  • Hypercoagulability
  • Thrombosis risk

ASJC Scopus subject areas

  • Pharmacology (medical)

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    Lobrano, A., Blanchard, K., Rock, W., Johnson, W., Schmieg, B., Borman, K., Araghizadeh, F., Minocha, A., & Abell, T. L. (2006). Assessing thrombosis risk in patients with idiopathic, diabetic, and postsurgical gastroparesis. Advances in Therapy, 23(5), 750-768. https://doi.org/10.1007/BF02850315