{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T07:54:15Z","timestamp":1789718055608,"version":"4.0.1"},"reference-count":36,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2022,2,25]],"date-time":"2022-02-25T00:00:00Z","timestamp":1645747200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Introduction<\/jats:title>\n<jats:p>Valproic acid (VPA) is a frequently prescribed anti-epileptic drug. Since its introduction side effects on hemostasis are reported. However, studies show conflicting results, and the clinical relevance is questioned. We aimed to determine the coagulopathies induced by VPA in patients who undergo high-risk surgery. The study results warrant attention to this issue, which might contribute to reducing bleeding complications in future patients.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>Between January 2012 and August 2020, 73 consecutive patients using VPA were retrospectively included. Extensive laboratory hemostatic assessment (including platelet function tests) was performed before elective high-risk surgery. Patient characteristics, details of VPA treatment, and laboratory results were extracted from medical records.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>46.6% of the patients using VPA (n = 73) showed coagulopathy. Mainly, platelet function disorder was found (36.4%). Thrombocytopenia was seen in 9.6% of the patients. Data suggested that the incidence of coagulopathies was almost twice as high in children as compared to adults and hypofibrinogenemia was only demonstrated in children. No association was found between the incidence of coagulopathies and VPA dosage (mg\/kg\/day).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>A considerable number of patients using VPA were diagnosed with coagulopathy, especially platelet function disorder. Further prospective studies are needed to confirm the need for comprehensive laboratory testing before elective high-risk surgery in these patients.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0264351","type":"journal-article","created":{"date-parts":[[2022,2,25]],"date-time":"2022-02-25T19:00:20Z","timestamp":1645815620000},"page":"e0264351","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":22,"title":["Assessment of need for hemostatic evaluation in patients taking valproic acid: A retrospective cross-sectional study"],"prefix":"10.1371","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9799-5777","authenticated-orcid":true,"given":"Demi S.","family":"Post","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arian","family":"van der Veer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olaf E. 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M.","family":"Beckers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Floor C. J. I.","family":"Heubel-Moenen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yvonne M. C.","family":"Henskens","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,2,25]]},"reference":[{"issue":"20","key":"pone.0264351.ref001","doi-asserted-by":"crossref","first-page":"2190","DOI":"10.1001\/jama.1978.03290200068031","article-title":"Valproic acid (Depakene). A new anticonvulsant agent.","volume":"240","author":"JR Lewis","year":"1978","journal-title":"JAMA"},{"issue":"10","key":"pone.0264351.ref002","first-page":"Cd003196","article-title":"Valproic acid, valproate and divalproex in the maintenance treatment of bipolar disorder.","volume":"2013","author":"A Cipriani","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"issue":"8","key":"pone.0264351.ref003","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1046\/j.1526-4610.2001.01142.x","article-title":"Valproic acid is effective in migraine prophylaxis at low serum levels: a prospective open-label study.","volume":"41","author":"S Kinze","year":"2001","journal-title":"Headache"},{"issue":"12","key":"pone.0264351.ref004","doi-asserted-by":"crossref","first-page":"661","DOI":"10.1056\/NEJM198003203021204","article-title":"Drug therapy: Valproic acid","volume":"302","author":"J Koch-Weser","year":"1980","journal-title":"N Engl J 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