| Autor: |
Pagnussatt Neto E; Department of Surgical Specialties and Anesthesiology, School of Medicine, Universidade Estadual Paulista (UNESP), Botucatu 18618-970, SP, Brazil.; São Vicente de Paulo Hospital, Passo Fundo 99010-112, RS, Brazil., Lopes da Costa PD; Department of Surgical Specialties and Anesthesiology, School of Medicine, Universidade Estadual Paulista (UNESP), Botucatu 18618-970, SP, Brazil., Gurgel SJT; Department of Surgical Specialties and Anesthesiology, School of Medicine, Universidade Estadual Paulista (UNESP), Botucatu 18618-970, SP, Brazil., Schmidt Azevedo P; Department of Internal Medicine, School of Medicine, Universidade Estadual Paulista (UNESP), Botucatu 18618-970, SP, Brazil., Modolo NSP; Department of Surgical Specialties and Anesthesiology, School of Medicine, Universidade Estadual Paulista (UNESP), Botucatu 18618-970, SP, Brazil., do Nascimento Junior P; Department of Surgical Specialties and Anesthesiology, School of Medicine, Universidade Estadual Paulista (UNESP), Botucatu 18618-970, SP, Brazil. |
| Abstrakt: |
There is a trend towards increased perioperative bleeding in patients with plasma fibrinogen levels < 200 mg/dL -1 . This study aimed to assess whether there is an association between preoperative fibrinogen levels and perioperative blood-product transfusion up to 48 h after major orthopedic surgery. This cohort study included 195 patients who underwent primary or revision hip arthroplasty for nontraumatic etiologies. Plasma fibrinogen, blood count, coagulation tests, and platelet count were measured preoperatively. A plasma fibrinogen level of 200 mg/dL -1 was the cutoff value used to predict blood transfusion. The mean (SD) plasma fibrinogen level was 325 (83) mg/dL -1 . Only thirteen patients had levels < 200 mg/dL -1 , and only one of them received a blood transfusion, with an absolute risk of 7.69% (1/13; 95%CI: 1.37-33.31%). Preoperative plasma fibrinogen levels were not associated with the need for blood transfusion ( p = 0.745). The sensitivity and the positive predictive value of plasma fibrinogen < 200 mg/dL -1 as a predictor of blood transfusion were 4.17% (95%CI: 0.11-21.12%) and 7.69% (95%CI: 1.12-37.99%), respectively. Test accuracy was 82.05% (95%CI: 75.93-87.17%), but positive and negative likelihood ratios were poor. Therefore, preoperative plasma fibrinogen level in hip-arthroplasty patients was not associated with the need for blood-product transfusion. |
