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Detection of subclinical vitamin K deficiency in neurosurgery with PIVKA-II
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- Dahlberg, Sofia (author)
- Lund University
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- Nilsson, Caroline Ulfsdotter (author)
- Lund University,Lunds universitet,Neurointensivvård,Forskargrupper vid Lunds universitet,Neurosurgical intensive care,Lund University Research Groups,Skåne University Hospital
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- Kander, Thomas (author)
- Lund University,Lunds universitet,Klinisk forskning inom anestesi och intensivvårdsmedicin,Forskargrupper vid Lunds universitet,Clinical Research in Anaesthesia and Intensive Care Medicine,Lund University Research Groups,Skåne University Hospital
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- (creator_code:org_t)
- 2017-03-20
- 2017
- English 8 s.
- In: Scandinavian Journal of Clinical and Laboratory Investigation. - : Informa UK Limited. - 0036-5513 .- 1502-7686. ; 77:4, s. 267-274
- Journal article (peer-reviewed)
Abstract
Subject headings
Close
- Vitamin K is known for supporting the carboxylation of hepatic coagulation proteins. Levels of proteins induced by vitamin K absence for factor II (PIVKA-II) reflect hypocarboxylated prothrombin and can be used to detect subclinical vitamin K deficiency. The aim of this study was to determine the prevalence of perioperative subclinical vitamin K deficiency among neurosurgical patients using PIVKA-II and investigate the existence of any correlation to standard coagulation assays. Also, the antitumor effects of vitamin K were reviewed. Thirty-five patients undergoing brain tumor resection were included. Blood samples were drawn preoperatively, at the end of surgery and in the morning after surgery. In addition to PIVKA-II, factor II and the Owren and Quick prothrombin times were analyzed. Seventeen of 35 patients had elevated PIVKA-II levels before surgery, which continued to be above normal range postoperatively. Median PIVKA-II and Owren prothrombin time (PT-INR) were increased on the morning day 1 postoperatively compared to before surgery, whereas Quick end-stage prothrombin time (EPT) decreased and factor II was unaffected. Postoperative complications were connected to high PIVKA-II increases. Positive correlations between PIVKA-II and factor II and body mass index (BMI) were found. In conclusion, PIVKA-II was increased in many patients preoperatively and then increased by the morning following surgery. Standard coagulation assays were largely non-pathological. Correlations were demonstrated between PIVKA-II and factor II and BMI. The effect of perioperative treatment with different vitamin K supplements should be investigated in future studies, as well as clinical trials evaluating their antitumor effects.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)
Keyword
- Brain neoplasm
- coagulation factors
- lipoproteins and cardiovascular markers
- liver enzymes
- neurosurgery
- nutrition and malabsorption
- surgery
- vitamin K
Publication and Content Type
- art (subject category)
- ref (subject category)
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