Shin Hyun-Jung, Min Byung-Hun, Na Hyo-Seok
Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, Seongnam-si, Republic of Korea.
Medicine (Baltimore). 2018 Jun;97(22):e10929. doi: 10.1097/MD.0000000000010929.
Revision total hip arthroplasty (THA) may cause intra- and postoperative massive bleeding. This prospective observational study evaluated if the maximum clot firmness of FIBTEM (MCFFIB) could act as a predictor of perioperative massive bleeding in revision THA.Fifty-eight adult patients undergoing revision THA were included. Pre- and postoperative MCFFIB, hematological and hemostatic laboratory data, as well as the amount of intra- and postoperative blood loss (IBL and PBL) were obtained.The change rate (MCFFIB-C) between the pre- and postoperative MCFFIB had a significant correlation with IBL (ρ = 0.431, P = .001). Moreover, PBL had a significant correlation with MCFFIB-C (ρ = 0.292, P = .026). The MCFFIB-C cut-off value of ≥ 29% showed the highest sensitivity and specificity for predicting IBL ≥ 1000 mL or PBL ≥500 mL. The incidence of red blood cell transfusion in the postoperative period was higher in patients showing MCFFIB-C ≥ 29% (34% vs 8%, P = .015).The change rate between pre- and postoperative MCFFIB values was correlated well with the amount of IBL or PBL. Moreover, particular change rate of MCFFIB could predict massive bleeding in revision THA.
全髋关节翻修术（THA）可能导致术中及术后大量出血。这项前瞻性观察性研究评估了FIBTEM的最大血凝块硬度（MCFFIB）是否可作为翻修THA围手术期大量出血的预测指标。纳入了58例接受翻修THA的成年患者。获取术前和术后的MCFFIB、血液学和止血实验室数据，以及术中及术后失血量（IBL和PBL）。术前和术后MCFFIB之间的变化率（MCFFIB-C）与IBL显著相关（ρ = 0.431，P = 0.001）。此外，PBL与MCFFIB-C显著相关（ρ = 0.292，P = 0.026）。MCFFIB-C cutoff值≥29%对预测IBL≥1000 mL或PBL≥500 mL具有最高的敏感性和特异性。MCFFIB-C≥29%的患者术后红细胞输血发生率更高（34%对8%，P = 0.015）。术前和术后MCFFIB值之间的变化率与IBL或PBL量密切相关。此外，MCFFIB的特定变化率可预测翻修THA中的大量出血。
