Unit:
Κατεύθυνση Θρόμβωση-Αιμορραγία-Ιατρική των μεταγγίσεωνLibrary of the School of Health Sciences
Author:
Καρακόιδα Χρυσούλα
Supervisors info:
Αργυρή Γιαλεράκη
Original Title:
Ψυχολογική και οικονομική διάσταση του εργαστηριακού ελέγχου θρομβοφιλίας
Summary:
Thrombophilia can be broadly defined as an increased tendency toward
hypercoagulability and venous thrombosis. There are several defined risk
factors for thrombosis and these are generally distinguished as either acquired
or congenital. Congenital risk factors include deficiencies or defects in
natural anticoagulants, such as antithrombin, Protein C and Protein S, and
genetic polymorphisms such as prothrombin G20210A and the Leiden mutation of
factor V, that leads to a condition commonly known as activated protein C
resistance. Acquired risk factors include antiphospholipid syndrome, prolonged
immobilization, surgery, increasing age, trauma, cancer, pregnancy, oral
contraceptives and hormone replacement therapy. There is ongoing debate
regarding the value of laboratory testing, whom and when to screen for these
markers, which tests and methodologies to use and the form and duration of
therapeutic management. Over the past decades, testing for thrombophilia has
increased tremendously for various indications, but whether the results of such
tests help in the clinical management has not been determined. Moreover,
learning of the presence of a mutation may provoke considerable anxiety and may
affect important life decisions, and since thrombophilia testing does not
influence clinical management, probably reflects a huge waste of resources. The
current study explores several important issues related to laboratory testing
of thrombophilia. Many of these issues appear to be simply overlooked by many
clinicians. And although there is potential significance in testing for various
thrombophilia-associated markers, it seems that sometimes this value is limited
when inappropriately applied. Several professional societies have developed
evidence-based guidelines, and still it is a fact that testing continues to be
performed frequently in patients who do not meet appropriate evidence based
criteria, which means that ordering practice requires scrutiny and that there
is a clear need for ongoing education.
Keywords:
Thrombophilia, Psycological impact, Cost-effectiveness, Screening, Risk factors
Number of references:
130
File:
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