Plasma Fibrinogen as a Predictor of Perioperative-Blood-Component Transfusion in Major-Nontraumatic-Orthopedic-Surgery Patients: A Cohort Study
Abstract
1. Introduction
2. Materials and Methods
Statistics
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Blood-Product Transfusion | |||||
---|---|---|---|---|---|
Clinical-Epidemiological Characteristics | Total (n = 195) | No (n = 171) | Yes (n = 24) | p-Value | |
Age (years) | 62.2 (11.2) | 61.7 (11.3) | 65.6 (10.3) | 0.119 ‡ | |
Sex | Female | 91 (46.7%) | 76 (83.5%) | 15 (16.5%) | |
Male | 104 (53.3%) | 95 (91.3%) | 9 (8.7%) | 0.126 § | |
Race | White | 194 (99.5%) | 170 (87.6%) | 24 (12.4%) | |
Mixed | 1 (0.5%) | 1 (100.0%) | 0 (0.0%) | 1.000 § | |
BMI * | 27.7 (4.4) | 27.9 (4.5) | 26.8 (4.2) | 0.259 ¶ | |
ASA-PS † | 1 | 35 (17.9%) | 31 (88.6%) | 4 (11.4%) | |
2 | 148 (75.9%) | 132 (89.2%) | 16 (10.8%) | ||
3 | 12 (6.2%) | 8 (66.7%) | 4 (33.3%) | 0.073 ** |
Blood-Product Transfusion | |||||
---|---|---|---|---|---|
Preoperative Laboratory Tests | Total (n = 195) | No. (n = 171) | Yes (n = 24) | p-Value | |
Fibrinogen (mg/dL−1) | 315 (83) | 316 (83) | 310 (79) | 0.745 § | |
Hemoglobin (g/dL−1) | 13.9 (1.3) | 14.0 (1.2) | 13.1 (1.8) | 0.028 § | |
Hematocrit (%) | 41.6 (4.1) | 42.1 (3.9) | 39.1 (5.1) | 0.006 ¶ | |
Platelets (count) | 230,756 (61,063) | 229,371 (61,298) | 240,625 (59,689) | 0.327 ¶ | |
Coagulation | PT * (seconds) | 12.2 (1.5) | 12.1 (1.5) | 12.7 (1.5) | 0.093 ¶ |
APTT † (seconds) | 28.7 (6.5) | 28.8 (6.7) | 27.4 (4.8) | 0.291 ¶ | |
INR ‡ | 1.0 (0.1) | 1.0 (0.1) | 1.1 (0.1) | 0.449 ¶ |
Test Feature | Results * |
---|---|
Sensitivity | 4.17% (95%CI: 0.11–21.12%) |
Specificity | 92.98% (95%CI: 88.06–96.32%) |
Positive predictive value | 7.69% (95%CI: 1.12–37.99%) |
Negative predictive value | 87.36% (95%CI: 86.30–88.35%) |
Accuracy | 82.05% (95%CI: 75.93–87.17%) |
Positive likelihood ratio | 0.59 (95%CI: 0.08–4.36) |
Negative likelihood ratio | 1.03 (95%CI: 0.94–1.13) |
Absolute risk (fibrinogen < 200 mg/dL−1) (A) | 7.69% (95%CI: 1.37–33.31%) |
Absolute risk (fibrinogen ≥ 200 mg/dL−1) (B) | 12.64% (95%CI: 8.57–18.25%) |
Relative risk (A/B) | 0.608 (95%CI: 0.089–4.158) |
Blood-Product Transfusion | |||||
---|---|---|---|---|---|
Variable | Total (n = 195) | No. (n = 171) | Yes (n = 24) | p-Value | |
Surgical technique (n) | THA * | 184 (94.4%) | 165 (89.7%) | 19 (10.3%) | |
Revision THA | 11 (5.6%) | 6 (54.5%) | 5 (45.5%) | 0.005 § | |
Operative time (minutes) | 120.2 (30.3) | 117.0 (26.7) | 143.1 (42.8) | 0.001 ¶ | |
Anesthetic technique (n) | Neuraxial | 188 (96.4%) | 165 (87.8%) | 23 (12.2%) | |
General | 5 (2.6%) | 4 (80.0%) | 1 (20.0%) | ||
Other | 2 (1.0%) | 2 (100.0%) | 0 (0.0%) | 0.757 ** | |
Antifibrinolytic therapy (n) | Yes, intravenous | 188 (96.4%) | 165 (87.8%) | 23 (12.2%) | |
Yes, intra-articular | 4 (2.1%) | 3 (75.0%) | 1 (25.0%) | ||
No | 3 (1.5%) | 3 (100.0%) | 0 (0.0%) | 0.601 ** | |
Hospitalization (n) | ICU † | 4 (2.1%) | 1 (25.0%) | 3 (75.0%) | |
PACU ‡ | 191 (97.9%) | 170 (89.0%) | 21 (11.0%) | 0.006 § | |
Postoperative hemoglobin (g/dL−1) | 10.5 (1.5) | 10.8 (1.3) | 8.61 (1.6) | <0.001 ¶ | |
Postoperative hematocrit (%) | 31.5 (4.3) | 32.2 (3.9) | 26.3 (3.7) | <0.001 †† |
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Pagnussatt Neto, E.; Lopes da Costa, P.D.; Gurgel, S.J.T.; Schmidt Azevedo, P.; Modolo, N.S.P.; do Nascimento Junior, P. Plasma Fibrinogen as a Predictor of Perioperative-Blood-Component Transfusion in Major-Nontraumatic-Orthopedic-Surgery Patients: A Cohort Study. Diagnostics 2023, 13, 976. https://doi.org/10.3390/diagnostics13050976
Pagnussatt Neto E, Lopes da Costa PD, Gurgel SJT, Schmidt Azevedo P, Modolo NSP, do Nascimento Junior P. Plasma Fibrinogen as a Predictor of Perioperative-Blood-Component Transfusion in Major-Nontraumatic-Orthopedic-Surgery Patients: A Cohort Study. Diagnostics. 2023; 13(5):976. https://doi.org/10.3390/diagnostics13050976
Chicago/Turabian StylePagnussatt Neto, Eugenio, Paula Daniele Lopes da Costa, Sanderland J. Tavares Gurgel, Paula Schmidt Azevedo, Norma S. Pinheiro Modolo, and Paulo do Nascimento Junior. 2023. "Plasma Fibrinogen as a Predictor of Perioperative-Blood-Component Transfusion in Major-Nontraumatic-Orthopedic-Surgery Patients: A Cohort Study" Diagnostics 13, no. 5: 976. https://doi.org/10.3390/diagnostics13050976
APA StylePagnussatt Neto, E., Lopes da Costa, P. D., Gurgel, S. J. T., Schmidt Azevedo, P., Modolo, N. S. P., & do Nascimento Junior, P. (2023). Plasma Fibrinogen as a Predictor of Perioperative-Blood-Component Transfusion in Major-Nontraumatic-Orthopedic-Surgery Patients: A Cohort Study. Diagnostics, 13(5), 976. https://doi.org/10.3390/diagnostics13050976