Clinical relevance of the fibrinogen uptake test in patients undergoing elective general abdominal surgery--relation to major thromboembolism and mortality. Fragmin Multicentre Study Group.
Postoperative thromboembolic complications were evaluated in 2578 patients undergoing elective abdominal surgery, all receiving prophylaxis with low molecular weight heparin. A positive fibrinogen uptake test (FUT) developed in 217 patients (8.4%), while 37 patients (1.4%) had major thromboembolism (TE, defined as proximal deep vein thrombosis and/or pulmonary embolism, verified with phlebography, pulmonary scintigraphy or autopsy). In only 14% a positive FUT was associated with a major TE event. In 19% of the patients with major TE the FUT was negative. In multiple logistic regression the independent predictors for major TE were partially different from those for positive FUT. Thirty day mortality was 3.0%. There were significant associations between both positive FUT and major TE on one hand and mortality on the other (relative risks 2.4 and 5.8, respectively). FUT is not a good predictor of major TE. Both positive FUT and major TE indicate a significant risk of postoperative death.
Flordal
P A
PA
Department of Surgery, Danderyd Hospital, Sweden.
Bergqvist
D
D
Ljungström
K G
KG
Törngren
S
S
D000005:Abdomen / Q000601:surgery*; D000328:Adult; D000368:Aged; D001780:Blood Coagulation Tests; D017558:Elective Surgical Procedures; D005260:Female; D005340:Fibrinogen / Q000378:metabolism*; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood* / Q000517:prevention & control; D012307:Risk Factors; D013923:Thromboembolism / Q000097:blood* / Q000401:mortality / Q000517:prevention & control
D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D005340:Fibrinogen