Preoperative plasma fibrinogen concentration, factor XIII activity, perioperative bleeding, and transfusions in elective orthopaedic surgery: A prospective observational study
| Autor: | Josef Zarhoud, Bengt I. Eriksson, Malin S. Carling, Helena Brisby, Anders Jeppsson |
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| Rok vydání: | 2015 |
| Předmět: |
Elective orthopaedic surgery
Male medicine.medical_specialty medicine.medical_treatment Arthroplasty Replacement Hip Blood Loss Surgical 030204 cardiovascular system & hematology Fibrinogen 03 medical and health sciences 0302 clinical medicine medicine Humans Blood Transfusion Orthopedic Procedures 030212 general & internal medicine Prospective Studies Arthroplasty Replacement Knee Perioperative Period Aged Factor XIII business.industry Hematology Perioperative Middle Aged Arthroplasty Spine Surgery Elective Surgical Procedures Spinal fusion Anesthesia Orthopedic surgery Observational study Female business medicine.drug |
| Zdroj: | Thrombosis research. 139 |
| ISSN: | 1879-2472 |
| Popis: | Major orthopaedic surgery involves a calculated risk of bleeding. In other groups of surgical patients, low preoperative plasma fibrinogen concentration and factor XIII (FXIII) activity have been associated with an elevated risk of bleeding. In the present study we investigated the association between preoperative fibrinogen plasma concentration and FXIII activity on bleeding and transfusion requirements in patients undergoing a spinal fusion procedure or hip or knee arthroplasty.Two hundred and forty-five adult patients undergoing spine fusion surgery (n=52), total unilateral primary hip arthroplasty (n=114), or total knee arthroplasty (n=79) were included in a prospective observational study. Blood samples were collected24h before surgery and analysed for fibrinogen concentration and FXIII activity. Intraoperative and postoperative bleeding volume and transfusion requirements were recorded.Spinal fusion surgery patients with a low preoperative fibrinogen concentration (≤2.5g/L) had a greater total perioperative median bleeding volume than patients with fibrinogen2.5g/L (2430 (400-6560) mL vs. 1390 (400-7420) mL, p=0.029). No significant association between low fibrinogen levels and perioperative bleeding volume was observed for arthroplasty patients. There was no association between low fibrinogen levels and transfusion requirements in any of the groups. Low FXIII activity was not significantly associated with bleeding volume and transfusion requirements in any group.Measurement of preoperative fibrinogen plasma concentration can identify spinal fusion patients with an increased risk of excessive perioperative bleeding. Measurement of FXIII activity cannot identify orthopaedic patients with elevated risk of bleeding. |
| Databáze: | OpenAIRE |
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