Abstract Number: PB1583
Meeting: ISTH 2020 Congress
Background: Approximately 100% of patients undergoing ECMO develop laboratory aVWD during their hospital stay, in the majority of cases without clinical bleeding.
Aims: Study aim was to collect more relevant data possibly associated with i) development of clinically relevant aVWD and/or ii) death during the follow-up.
Methods: Within a 3-year period 338 white patients aged 18 to 88 years (median: 60) were enrolled (male 64.5%).
Results: The yearly incidence of patients with aVWD with clinical relevant bleeding symptoms in this high risk cohort was 23% (78/ 338) with a death rate of 74% within a median time of 9 days (1 – 229) following ECMO start. Of note, 15 of 78 subjects with symptomatic aVWD received aspirin or clopidogrel, vitamin-K-antagonists, heparins, argatroban and/ or anti-factor-Xa inhibitors. As treatment for bleeding episodes blood product administration was performed concomitant with coagulation factor concentrates. The 78 subjects with symptomatic aVWD received von-Willebrand-factor concentrates, in median 6.000 IU (min – max: 1.000 – 157.000 IU) per patient affected. Logistic regression analysis adjusted for age and gender revealed that i) the presence of blood group 0 versus non-0 (Odds ratio (OR)/ 95% Confidence interval (CI) 1.76/ 1.005 – 3.11) and the overall need for blood products administered per unit (OR/ CI 1.1/ 1.01 – 1.02) were independently associated with the development of clinically relevant aVWD. ii) In the entire ECMO cohort older age (increase per year) at ECMO start (OR/ CI 1.01/ 1.01 – 1.03) and the amount of blood product units necessitated were related with death (OR/ CI 1.01/ 1.002 – 1.014) but not associated with the development of clinically relevant aVWD.
Conclusions: In the present cohort study we found a clinical relevant bleeding incidence of 23% in subjects with aVWD. The latter, however, was not associated with death following the ECMO procedure.
To cite this abstract in AMA style:Bajorat T, Panholzer B, Haneya A, Kowalski D, Juhl D, Rocke A, Shneyder M, Kuta PM, Clausnizer H, Nowak-Göttl U. Acquired von-Willebrand-Disease (aVWD) in ECMO Patients: a 3-Year Cohort Study [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/acquired-von-willebrand-disease-avwd-in-ecmo-patients-a-3-year-cohort-study/. Accessed August 15, 2022.
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