Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria.
Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, 8036, Graz, Austria.
Dig Dis Sci. 2024 Oct;69(10):3894-3900. doi: 10.1007/s10620-024-08651-y. Epub 2024 Sep 19.
Factor XIII plays a key role within the coagulation cascade.
We aimed to investigate the relevance of factor XIII activity on the outcome of patients with gastrointestinal bleedings.
In this retrospective, single-center study patients with gastrointestinal bleeding and measurement of factor XIII activity were included. The primary endpoint was the number of red blood cell transfusions in patients with reduced factor XIII activity (< 70%) compared to patients with normal activity. Additionally, the influence of factor XIII substitution was assessed.
Ninety-seven patients (median age: 64 [IQR 55, 77] years, 31 (32%) females) were included in the analysis. Fifty-six (58%) patients suffered from an upper gastrointestinal bleeding. 66 (68%) patients had a factor XIII activity < 70% and 24 (36%) of those received factor XIII substitution. Patients with reduced FXIII activity needed significantly more red blood cell transfusions than patients with normal activity (9 [5, 12] vs. 4 [1, 8], p < 0.001). Patients receiving factor XIII substitution showed a trend toward a decreased need for transfusions after substitution (0 [0, 5] vs. 3 [1, 6], p = 0.066). Factor XIII activity correlated negatively with the INR (r = -0.24, p = 0.018) and positively with hemoglobin levels (r = 0.28, p = 0.006) and with thrombocyte counts (r = 0.30, p = 0.003).
The present study shows an association of factor XIII activity with the requirement of blood transfusions in patients with gastrointestinal bleedings and indicates a potential benefit of factor XIII substitution. Factor XIII activity seems to be dependent from the amount of blood loss and the global coagulation parameters.
凝血级联反应中，因子 XIII 发挥着关键作用。
本研究旨在探究因子 XIII 活性与胃肠道出血患者预后的相关性。
本回顾性单中心研究纳入了伴有胃肠道出血且因子 XIII 活性可测的患者。主要终点为因子 XIII 活性降低（＜70%）的患者与活性正常的患者相比，所需输注的红细胞量。此外，还评估了因子 XIII 替代治疗的影响。
97 例患者（中位年龄：64 [IQR 55, 77] 岁，31 [32%] 例女性）纳入分析。56 例（58%）患者患有上消化道出血。66 例（68%）患者因子 XIII 活性＜70%，其中 24 例（36%）接受了因子 XIII 替代治疗。因子 XIII 活性降低的患者需要输注的红细胞量显著多于活性正常的患者（9 [5, 12] vs. 4 [1, 8]，p＜0.001）。接受因子 XIII 替代治疗的患者在替代治疗后输血需求呈下降趋势（0 [0, 5] vs. 3 [1, 6]，p＝0.066）。因子 XIII 活性与 INR 呈负相关（r＝-0.24，p＝0.018），与血红蛋白水平呈正相关（r＝0.28，p＝0.006），与血小板计数呈正相关（r＝0.30，p＝0.003）。
本研究表明，胃肠道出血患者的因子 XIII 活性与输血需求相关，并提示因子 XIII 替代治疗可能有益。因子 XIII 活性似乎依赖于出血量和整体凝血参数。
