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Göteborgs universitets publikationer

Preoperative plasma fibrinogen concentration, factor XIII activity, perioperative bleeding, and transfusions in elective orthopaedic surgery: A prospective observational study

Författare och institution:
Malin S Carling (Institutionen för kliniska vetenskaper, sektionen för anestesi, biomaterial och ortopedi, Avdelningen för ortopedi); Josef Zarhoud (Institutionen för kliniska vetenskaper); Anders Jeppsson (Institutionen för medicin, avdelningen för molekylär och klinisk medicin); Bengt I. Eriksson (Institutionen för kliniska vetenskaper, sektionen för anestesi, biomaterial och ortopedi); Helena Brisby (Institutionen för kliniska vetenskaper)
Publicerad i:
Thrombosis Research, 139 s. 142-147
Artikel, refereegranskad vetenskaplig
Sammanfattning (abstract):
Background: 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. Methods: 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 collected <24 h before surgery and analysed for fibrinogen concentration and FXIII activity. Intraoperative and postoperative bleeding volume and transfusion requirements were recorded. Results: Spinal fusion surgery patients with a low preoperative fibrinogen concentration (<= 2.5 g/L) had a greater total perioperative median bleeding volume than patients with fibrinogen > 2.5 g/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. Conclusion: 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.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
Klinisk medicin
Orthopaedic surgery, Haemorrhage, Fibrinogen, Factor XIII, Arthroplasty, Spinal fusion, blood-loss, cardiac-surgery, knee arthroplasty, fusion surgery, total, hip, risk, Hematology, Cardiovascular System & Cardiology
Postens nummer:
Posten skapad:
2016-03-18 11:39
Posten ändrad:
2016-06-10 10:43

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