Differences in perioperative coagulation between Japanese and other ethnic groups undergoing laparoscopic cholecystectomy

Iwade, Motoyo; Iwade, Kazunori; Nomura, Masatoshi; Ozaki, Makoto

doi:10.1007/s00464-002-9282-z

Cited by 9 publications

(10 citation statements)

References 8 publications

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“…It has been noted for years that East Asian populations demonstrate a lower incidence of baseline thrombotic complications such as deep vein thrombosis (DVT) and pulmonary embolism (PE) than in Caucasians. 8,9 These observations of epidemiolog-ical differences of coagulation across distinct ethnic populations have arisen from studies investigating risk factors for cardiac and cerebral vascular events. 10 The annual incidence of venous thromboembolism (VTE) in the United States is generally accepted to range from 70 to 120 events per 100,000 people.…”

Section: Baseline Differences In the Incidence Of Thrombosis Between mentioning

confidence: 99%

“…Although no studies have explored this phenomenon in the context of free flap procedures, recognizing differences in response to injury may help explain observed differences in thrombotic and hemorrhagic flap complications between the East and West. 8,18,19 Iwade et al evaluated the coagulation profiles of 27 Japanese patients undergoing elective laparoscopic cholecystectomy. Levels of coagulation factors were measured prior to start of anesthesia (baseline), postoperatively, and 24 hours following the procedure.…”

Section: The Surgical Patient: Differences In the Hemostatic Responsementioning

confidence: 99%

“…Levels of coagulation factors were measured prior to start of anesthesia (baseline), postoperatively, and 24 hours following the procedure. 8 The authors concluded that platelets and coagulation factors may contribute differently to the postoperative response in Asians and Caucasians. Coagulation was tracked with thromboelastography (TEG), D-dimer, thrombin-antithrombin complex, and prothrombin fragments 1 þ 2 (F1 þ 2).…”

Section: The Surgical Patient: Differences In the Hemostatic Responsementioning

confidence: 99%

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Differences in Coagulation Among Asians and Caucasians and the Implication for Reconstructive Microsurgery

Singhal

Smorodinsky²,

Guo

2010

J reconstr Microsurg

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Microvascular reconstructive surgery has seen a revival with the introduction of muscle-sparing perforator flaps. Recognition of potential ethnic differences in coagulation profiles would be important to a microvascular surgeon. Based on clinical observations, we hypothesize that Asian patients have a less thrombogenic coagulation profile than Caucasians. An extensive retrospective review was performed. The annual incidence of venous thromboembolism in the United States is generally accepted to range from 70 to 120 events per 100,000 people versus 16 to 17 events per 100,000 persons in Asia. Autopsy analysis of pulmonary embolism incidence was noted to be 15% in North Americans and less than 1% in Asian populations. Thromboelastography analysis of Asian and Caucasian patients undergoing cholecystectomy revealed different hemostatic mechanisms. Comparison of Asians and Caucasians undergoing the Fontan procedure revealed significantly lower postoperative factor levels in Asians than Caucasians. Baseline comparison of factor and serum levels revealed Asians with the least thrombogenic profiles compared with other ethnic groups. Asians and Caucasians demonstrate different baseline rates of deep vein thrombosis and pulmonary embolism, different hemostatic responses to surgery, and different baseline levels of clotting factors. Further study may lead to better pre-, intra-, and postoperative care of the free flap patient based on their ethnic coagulation profile.

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Section: Baseline Differences In the Incidence Of Thrombosis Between mentioning

confidence: 99%

Section: The Surgical Patient: Differences In the Hemostatic Responsementioning

confidence: 99%

Section: The Surgical Patient: Differences In the Hemostatic Responsementioning

confidence: 99%

See 1 more Smart Citation

Differences in Coagulation Among Asians and Caucasians and the Implication for Reconstructive Microsurgery

Singhal

Smorodinsky²,

Guo

2010

J reconstr Microsurg

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“…The need for such a low dose of EN in our population is not well explained, but a number of possibilities exist. First, there is the possibility of ethnic differences between our studied population and those reported in the literature [11] . Second, the use of exclusively biocompatible materials in our study may have reduced the dose needed [12] .…”

Section: Discussionmentioning

confidence: 87%

Long-Term Use of Low-Molecular-Weight Heparin in Hemodialysis Patients: A 7-Year Experience

Bernieh

Boobes²,

Hakim³

et al. 2009

Blood Purif

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Background: Low-molecular-weight-heparin (LMWH) is not routinely used as anticoagulant in hemodialysis (HD). The ideal dose and the safety of long-term use are not known. Methods: A prospective three-phase interventional study. Phase 1 involved dose titration, phase 2 safety and efficacy and phase 3 routine practice. Results: During 7 years of the use of the LMWH enoxaparin (EN), 236 patients were treated with a total number of 60,987 HD sessions. The mean dose used during the titration phase was 0.43 ± 0.16 mg/kg/session, which was subsequently reduced in phase 3 to 0.36 ± 0.14 mg/kg/session. The long-term effects of EN on the platelet count and lipid profile were comparable to unfractionated heparin. Conclusion: The long-term use of LMWH (EN) with a reduced dose in HD is practical and safe.

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“…[1][2][3][4][5][6][7] Although similar guidelines do not exist within the microsurgery realm, recent studies-including ours-have shed light on the difference in coagulative responses between East Asian and Westerners and its significance in the propen-sity for thrombotic or hemorrhagic complications. [8][9][10][11][12][13][14][15] We aim to examine this phenomenon in patients undergoing microsurgical breast reconstruction.With the growing popularity of microvascular surgery, minimizing complications has become a priority. While bleeding at both donor and recipient sites can be catastrophic, another devastating complication-flap failure-is reported between 0.3 and 5% in breast free flaps and is almost…”

mentioning

confidence: 99%

Ethnic Disparities in Thrombotic and Bleeding Diatheses Revisited: A Systematic Review of Microsurgical Breast Reconstruction across the East and West

Bene

Minasian

Khan

et al. 2021

J Reconstr Microsurg

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Background Ethnicity has been shown to play a role in disparate coagulative responses between East Asian and Caucasian patients undergoing nonmicrovascular surgery. In this study, we sought to further investigate this hematologic phenomenon between the two ethnic groups within the field of microsurgical breast reconstruction. Methods A systematic review examining the reported incidence of microvascular thrombosis and all-site bleeding among breast free flaps in East Asians and Westerners was performed. Statistical analysis was performed using the chi-square test. Results Ten East Asian studies with 581 flaps and 99 Western studies with 30,767 flaps were included. A statistically significant higher rate of thrombotic complications was found in Westerners compared with East Asians (4.2 vs. 2.2%, p = 0.02). Conversely, bleeding events were more common in East Asians compared with Westerners (2.6 vs. 1.2%, p = 0.002). Conclusion There appears to be an ethnicity-based propensity for thrombosis in Westerners and, conversely, for bleeding in East Asians, as evident by the current systematic review of microvascular breast reconstruction data. It is therefore advisable to consider ethnicity in the comprehensive evaluation of patients undergoing microsurgical procedures.

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Differences in perioperative coagulation between Japanese and other ethnic groups undergoing laparoscopic cholecystectomy

Abstract: Whereas clotting factor activation sthenia is common in Europe and North America, thrombocyte function sthenia occurs in Japanese patients. This difference may account for the differing incidences of phlebothrombosis in Japanese and white populations.

Cited by 9 publications

References 8 publications

Differences in Coagulation Among Asians and Caucasians and the Implication for Reconstructive Microsurgery

Differences in Coagulation Among Asians and Caucasians and the Implication for Reconstructive Microsurgery

Long-Term Use of Low-Molecular-Weight Heparin in Hemodialysis Patients: A 7-Year Experience

Ethnic Disparities in Thrombotic and Bleeding Diatheses Revisited: A Systematic Review of Microsurgical Breast Reconstruction across the East and West

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