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Impaired Coagulation Status in the Crohn's Disease Patients Complicated with Intestinal Fistula
Yuan Li1, Jian-An Ren1, Ge-Fei Wang1
1Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, China.
Insights
Crohn's disease (CD) with intestinal fistula significantly impairs coagulation, showing longer prothrombin time and lower platelet counts. Surgical resection of fistulas can improve coagulation status in CD patients.
Area of Science:
- Gastroenterology
- Hematology
- Surgical Complications
Background:
- Intestinal fistula is a frequent complication of Crohn's disease (CD), often necessitating surgical intervention.
- CD patients with intestinal fistulas exhibit distinct clinical characteristics and outcomes compared to those without.
- The impact of intestinal fistulas on the coagulation status of CD patients remains an area requiring investigation.
Purpose of the Study:
- To investigate alterations in coagulation status in Crohn's disease patients with intestinal fistulas.
- To compare coagulation parameters between CD patients with and without intestinal fistulas.
- To assess the effect of intestinal fistula resection on coagulation parameters in CD patients.
Main Methods:
- Retrospective analysis of 190 Crohn's disease patients diagnosed between January 2014 and September 2015.
- Collection of baseline clinical characteristics and laboratory indices, including coagulation parameters, at initial admission and 7 days post-resection.
- Statistical comparison using Student's t-test and Wilcoxon rank-sum test to identify significant differences between groups.
Main Results:
- Patients with intestinal fistulas had significantly prolonged prothrombin time (PT) and lower platelet (PLT) counts compared to those without.
- Multivariate analysis confirmed that intestinal fistula is independently associated with prolonged PT and reduced PLT count.
- Following intestinal fistula resection in 65 patients, a significant improvement in PT was observed.
Conclusions:
- Intestinal fistula is significantly associated with impaired coagulation status in Crohn's disease patients.
- Coagulation parameters, particularly prothrombin time, show improvement after surgical resection of intestinal fistulas.
- These findings highlight the importance of monitoring and managing coagulation status in CD patients with intestinal fistulas.
Background:
Intestinal fistula is one of the common complications of Crohn's disease (CD) that might require surgical treatment. The clinical characteristics and outcomes of CD with intestinal fistula are much different from CD alone. This study was to investigate whether the coagulation status of CD is changed by intestinal fistula.
Methods:
Data were retrospectively analyzed for 190 patients with a definitive diagnosis of CD who were registered at the Jinling Hospital between January 2014 and September 2015. Baseline clinical characteristics and laboratory indices of initial admission and 7 days after intestinal fistula resections were collected. Student's t-test and the Wilcoxon rank-sum test were used to compare differences between the two groups.
Results:
Compared with CD patients without intestinal fistula, prothrombin time (PT) in patients with intestinal fistula was significantly longer (12.13 ± 1.27 s vs. 13.18 ± 1.51 s, P < 0.001 in overall cohort; 11.56 ± 1.21 s vs. 12.61 ± 0.73 s, P = 0.001 in females; and 12.51 ± 1.17 s vs. 13.37 ± 1.66 s, P = 0.003 in males). Platelet (PLT) count was much lower in intestinal fistula group than in nonintestinal fistula group (262.53 ± 94.36 × 109/L vs. 310.36 ± 131.91 × 109/L, P = 0.009). Multivariate logistic regression showed that intestinal fistula was significantly associated with a prolonged PT (odds ratio [OR] = 1.900, P < 0.001), a reduced amount of PLT (OR = 0.996, P = 0.024), and an increased operation history (OR = 5.408, P < 0.001). Among 65 CD patients receiving intestinal fistula resections, PT was obviously shorter after operation than baseline (12.28 ± 1.16 s vs. 13.02 ± 1.64 s, P = 0.006).
Conclusions:
Intestinal fistula was significantly associated with impaired coagulation status in patients complicated with CD. Coagulation status could be improved after intestinal fistula resections.
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