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Abstract
Background: There are only limited data in the literature on the thrombotic risk of patients with Clostridium difficile (CD) colitis, although this disease is widespread throughout the world.
Objective: The aim of this study was to explore thrombin generation in these patients – the best way to evaluate their coagulation.
Methods: A prospective observational study was conducted during 15 months on hospitalized patients with CD colitis. Thrombin generation was performed in platelet-poor plasma using a Ceveron® alpha analyzer and was compared with a group of volunteer control subjects.
Results: Thirty-three patients and 51 control subjects were enrolled in the study. Two biomarkers – mean velocity index and peak thrombin – were significantly higher in patient group, compared to the control subjects (p = 0.010, respectively, p = 0.0395). This pattern of thrombin generation suggests that patients with CD colitis without septic shock have a potential thrombotic risk. The mean velocity index significantly correlated with the estimated related risk of death according to the Charlson age-comorbidity index.
Conclusions: The higher values of thrombin generation suggest that CD colitis increases the thromboembolic risk. The pattern of thrombin generation could identify patients with particularly higher thromboembolic risk. They are potential candidates for thromboprophylaxis strategies and monitorization.
Acknowledgements
The authors thank the following colleagues: Prof Adrian Boicean, Prof Călin Cipăian, Dr Bogdan Bratu, Dr Neli M Stopici for their advice, suggestions and help in obtaining the necessary information for the study, and apologize to the authors who could not be cited due to the vastness of the investigated field.
Disclosure statement
The authors declare that there are no conflicts of interest. All authors have contributed equally to writing the article. R. G. Mihăilă was responsible for statistical design and analysis which have been verified and approved by the other authors.