Coagulation Profile Comparison Between Primary Brain Tumor and Secondary Brain Tumor

摘要

To know the prevalence, the profile and the influencing factors of coagulopathy in primary and secondary brain tumor. This is a cross sectional study from medical records of adult brain tumor patients in Ciptomangunkusumo Hospital, Jakarta, from January 2009–May 2016. Brain tumorwas diagnosed based on clinical history, head CT scan/MRI, and histopathology of the brain or any other primary organs. Coagulation profile measurements include prothrombine time (PT), activated partial thromboplastin time (APTT), fibrinogen and D-dimer serum. Subjects were classified intoprimary and secondary brain tumor. The study recruited 135 patients, with median age of 48 (18–68) years old. Primary brain tumor was slightly predominant than the secondary (52,6% vs. 47,4%), among which astrocytoma was the most frequent (46,5%). Lung cancer had highest incidence inthe secondary brain tumor group (39,1%) and was the primary tumor with the highest fibrinogen level (424,70 (239,0–900,0; p 0,016). Most of the subjects (79,4%) are diagnosed with coagulopathy. The proportion of coagulopathy in secondary brain tumor is significantly higher thanprimary brain tumor (88,5% vs. 72,7%, p 0,041). Median or mean PT, APTT and fibrinogen levels are higher in the secondary brain tumor group. Multivariate analysis proved that tumor type had strongest correlation with median fibrinogen levels. Among the confounding factors, sepsis significantlyinfluenced the increase of APTT and fibrinogen levels (p 0,009 and 0,002). Coagulopathy proportion was higher in secondary brain tumor, with also higher mean or median PT, APTT and fibrinogen levels. In the secondary brain tumor, patient with lung cancer origin had a significant highermedian fibrinogen levels compared to other primary tumor. Sepsis was the only complications that had a significant correlation with mean APTT levels and median.