Hemostasis Alterations in Neurosurgical Patients

Prospective Study on Hemostasis Alterations in Patients Undergoing Neuro Surgical Glioma Resection Acronym: (ABCD Study: Acute Brain Coagulopathy Development Study)

Prospective, observational study aimed to investigate the specific hemostatic alterations in patients undergoing glial tumor resection.

Brain parenchyma express tissue factor and other coagulation factors in high concentrations. In addition, neuro critical patients (NCP) may present platelet dysfunction, hyperfibrinolysis, hypo coagulation and / or hyper coagulation status, early after the injury. It is not known whether these alterations of hemostasis are due to a specific brain response to aggression, or they are included into a systemic response. This prospective, observational study is aimed to investigate the coagulation disorders specifically associated with cerebral aggression.

This is a prospective, cohort study including (calculated sample size) a study group of patients undergoing elective surgery (glial tumors) and other one undergoing colo rectal surgery. Alterations of the hemostasis will be evaluated by clotting tests, thromboelastometry and tests for platelet function. Samples will be drawn before and after surgical procedures. Multiple statistical comparisons intra and inter groups will be performed.

Inclusion Criteria:

• Patients undergoing elective surgeries: glioma or colon cancer resections.

Exclusion Criteria:

• Severe bleeding leading to patient's' death.
• Incomplete tumor resection.
• Peri operative complications leading to severe bleeding or prolonged ICU or hospital stay.
• Peri operative blood components transfusion.
• Peri operative transfusion of concentrate coagulation factors.
• Intake of anti coagulant and / or antiaggregant drugs 7 days before surgery.
• History of coagulopathy.
• Inform consent denied for patients or relatives.