[Rapid diagnosis of blood coagulation disorders].
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The lapse of coagulation disorders in polytraumatized patients is regarded as a substantial part of complications in the course of traumatic-hemorrhagic shock. In 71 polytraumatized patients blood-clotting tests were performed and showed that changes may already occur at a very early stage of the shock. The extent of these changes is closely related to the degree of the injury. It could be demonstrated that prompt shock-treatment and maintenance of adequate circulation as well as administration of low doses of heparin are important for spontaneous recompensation of the hemostatic defect.
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In 34 patients admitted in Neurological Intensive Care Unit, for a cerebral hematoma by ruptured arterio-venous malformation, are present in 26 patients, on the first day. In many cases, the APTT is increased and this can be respected. These disorders do not seem to modify the incidence of delayed hemorrhage, except for the severe perturbances, related to a DIC or an hepatic deficiency. In these cases, the delayed hemorrhage must be prevented by transfusions of platelets and/or freeze fresh plasma.
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In order to assess the influence of an inherited blood coagulation disorder in individuals who developed cancer, a mail survey of physicians who care for individuals with a bleeding diathesis was evaluated. Sixty-one individuals in an estimated population of 10,500 with both disorders were identified. An apparent increase in the incidence of cancer in the genitourinary and musculoskeletal systems was noted. However, in the largest group ( hemophilia) the primary site of cancer was similar to an age and sex matched population. There did not appear to be a change in the onset of metastatic disease in these individuals, as compared to an individual with cancer who did not have an inherited blood coagulation disorder.
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