Kalai Firas, Faten Olfa, Ben Brahem Sabrine, Ardhaoui Ichraf, Rebai Lotfi
Department of Anesthesiology and Critical Care, Traumatology and Severe Burns Center, Ben Arous, Tunisia.
Surg Neurol Int. 2025 May 30;16:204. doi: 10.25259/SNI_125_2025. eCollection 2025.
Postoperative fibrinogen deficiency after surgical removal of a brain tumor can cause potentially serious complications, such as intracranial hematoma, and worsen the patient's outcome. Our study aimed to determine the prevalence of hypofibrinogenemia after resection of intracranial tumor, to identify the risk factors for this abnormality, and to evaluate the prognosis of patients with this hemostasis disorder.
We conducted a prospective, descriptive study including 120 patients who presented for brain tumor resection without preoperative fibrinogen deficiency and had given their consent to participate in the study. We determined the fibrinogen level the day before the procedure, at 1 h and 24 h postoperatively. We determined the prevalence of postoperative fibrinogen deficiency. Postoperative complications, neurological status of the patient, and mortality at 3 months were subsequently recorded.
Forty-eight patients presented postoperative fibrinogen deficiency with a high prevalence of 40%. Our study identified three predictive independent risk factors of fibrinogen deficiency after surgical resection of brain tumor: histological type of meningioma ( = 0.015), prolonged duration of surgery (more than 195 min) ( = 0.045), and use of surgicel as a hemostatic product intraoperatively ( = 0.009). Postoperative hematoma and sensory-motor deficit were significantly associated with postoperative fibrinogen deficiency ( < 0.001). Patients with postoperative hypofibrinogenemia had worse Glasgow Outcome Scale-Extended at discharge and after 3 months. On the other hand, fibrinogen deficiency after surgical removal of the intracranial tumor was not significantly associated with increased postoperative mortality.
We found a high prevalence of hypofibrinogenemia after brain tumor resection (40%). This anomaly increases the risk of intracranial hematoma. It, therefore, deserves the attention of the practitioner to correct it rapidly and avoid its potentially serious complications.
脑肿瘤手术切除后发生的术后纤维蛋白原缺乏可导致潜在的严重并发症，如颅内血肿，并使患者的预后恶化。我们的研究旨在确定颅内肿瘤切除术后低纤维蛋白原血症的患病率，识别这种异常的危险因素，并评估患有这种止血障碍的患者的预后。
我们进行了一项前瞻性描述性研究，纳入120例术前无纤维蛋白原缺乏且同意参与研究的脑肿瘤切除术患者。我们在手术前一天、术后1小时和24小时测定纤维蛋白原水平。我们确定术后纤维蛋白原缺乏的患病率。随后记录术后并发症、患者的神经状态以及3个月时的死亡率。
48例患者出现术后纤维蛋白原缺乏，患病率高达40%。我们的研究确定了脑肿瘤手术切除后纤维蛋白原缺乏的三个独立预测危险因素：脑膜瘤的组织学类型（=0.015）、手术时间延长（超过195分钟）（=0.045）以及术中使用外科用明胶海绵作为止血产品（=0.009）。术后血肿和感觉运动功能障碍与术后纤维蛋白原缺乏显著相关（<0.001）。术后低纤维蛋白原血症患者出院时和3个月后的格拉斯哥扩展预后量表评分较差。另一方面，颅内肿瘤手术切除后的纤维蛋白原缺乏与术后死亡率增加无显著相关性。
我们发现脑肿瘤切除术后低纤维蛋白原血症的患病率很高（40%）。这种异常增加了颅内血肿的风险。因此，值得从业者注意，以便迅速纠正并避免其潜在的严重并发症。
