Plasma Fibrinogen as a Predictor of Perioperative-Blood-Component Transfusion in Major-Nontraumatic-Orthopedic-Surgery Patients: A Cohort Study

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dc.contributor.authorPagnussatt Neto, Eugenio [UNESP]
dc.contributor.authorLopes da Costa, Paula Daniele [UNESP]
dc.contributor.authorGurgel, Sanderland J. Tavares [UNESP]
dc.contributor.authorSchmidt Azevedo, Paula [UNESP]
dc.contributor.authorModolo, Norma S. Pinheiro [UNESP]
dc.contributor.authordo Nascimento Junior, Paulo [UNESP]
dc.contributor.institutionUniversidade Estadual Paulista (UNESP)
dc.contributor.institutionSão Vicente de Paulo Hospital
dc.date.accessioned2023-07-29T14:00:57Z
dc.date.available2023-07-29T14:00:57Z
dc.date.issued2023-03-01
dc.description.abstractThere 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.en
dc.description.affiliationDepartment of Surgical Specialties and Anesthesiology School of Medicine Universidade Estadual Paulista (UNESP), SP
dc.description.affiliationSão Vicente de Paulo Hospital, RS
dc.description.affiliationDepartment of Internal Medicine School of Medicine Universidade Estadual Paulista (UNESP), SP
dc.description.affiliationUnespDepartment of Surgical Specialties and Anesthesiology School of Medicine Universidade Estadual Paulista (UNESP), SP
dc.description.affiliationUnespDepartment of Internal Medicine School of Medicine Universidade Estadual Paulista (UNESP), SP
dc.identifierhttp://dx.doi.org/10.3390/diagnostics13050976
dc.identifier.citationDiagnostics, v. 13, n. 5, 2023.
dc.identifier.doi10.3390/diagnostics13050976
dc.identifier.issn2075-4418
dc.identifier.scopus2-s2.0-85149726137
dc.identifier.urihttp://hdl.handle.net/11449/249048
dc.language.isoeng
dc.relation.ispartofDiagnostics
dc.sourceScopus
dc.subjectanesthesia
dc.subjectblood transfusion
dc.subjectblood-coagulation tests
dc.subjectfibrinogen
dc.subjectorthopedic surgeries
dc.titlePlasma Fibrinogen as a Predictor of Perioperative-Blood-Component Transfusion in Major-Nontraumatic-Orthopedic-Surgery Patients: A Cohort Studyen
dc.typeArtigo
unesp.author.orcid0000-0002-0590-9286[1]
unesp.author.orcid0000-0002-5843-6232[4]
unesp.author.orcid0000-0002-2323-9159[6]

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