Fibrinolytic activity in plasma after gynecological and urological surgery.
Fibrinolytic activity was studied in 51 patients subjected to major surgery (27 urological and 24 gynecological) without prophylaxis. Postoperative deep-vein thrombosis (DVT) was diagnosed by venography in 6 patients (11%). Blood samples were obtained preoperatively and on days 1, 3 and 7 postoperatively. Reduced fibrinolytic activity, as determined by prolongation of euglobulin lysis time (ELT), decrease in plasminogen activators on fibrin plate and decrease in tissue-type plasminogen activator (t-PA) activity were present postoperatively. Moreover, a marked increase in short duration in fast-acting inhibitor (PA-inhibitor) levels was observed on postoperative day 1 (p less than 0.001). Patients with DVT had higher fibrinogen degradation product (FDP) levels on postoperative days 3 and 7 (p less than 0.02). Preoperative PA-inhibitor activity was higher (p less than 0.02) in those patients who developed postoperative DVT. It is concluded that the decrease in t-PA and the increase in PA-inhibitor may contribute to the reduced postoperative fibrinolytic activity after major surgery. PA-inhibitor may represent a useful predictive marker of postoperative DVT.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005342:Fibrinolysis; D005831:Genital Diseases, Female / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood*; D013924:Thrombophlebitis / Q000097:blood; D010959:Tissue Plasminogen Activator / Q000097:blood; D014570:Urologic Diseases / Q000601:surgery*
D005338:Fibrin Fibrinogen Degradation Products; D010959:Tissue Plasminogen Activator