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possible role of soluble fibrin monomer complex after gastroenterological surgery
Masatoshi Kochi1, Manabu Shimomura1, Takao Hinoi1
1Masatoshi Kochi, Hiroyuki Egi, Kazuaki Tanabe, Tomohiro Adachi, Hideki Ohdan, Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima city, Hiroshima 734-8551, Japan.
Aim:
To examine the role of soluble fibrin monomer complex (SFMC) in the prediction of hypercoagulable state after gastroenterological surgery.
Methods:
We collected data on the clinical risk factors and fibrin-related makers from patients who underwent gastroenterological surgery at Hiroshima University Hospital between April 1, 2014 and March 31, 2015. We investigated the clinical significance of SFMC, which is known to reflect the early plasmatic activation of coagulation, in the view of these fibrin related markers.
Results:
A total of 123 patients were included in the present study. There were no patients with symptomatic VTE. Thirty-five (28%) patients received postoperative anticoagulant therapy. In the multivariate analysis, a high SFMC level on POD 1 was independently associated with D-dimer elevation on POD 7 (OR = 4.31, 95%CI: 1.10-18.30, P = 0.03). The cutoff SFMC level was 3.8 μg/mL (AUC = 0.78, sensitivity, 63%, specificity, 89%). The D-dimer level on POD 7 was significantly reduced in high-SFMC patients who received anticoagulant therapy in comparison to high-SFMC patients who did not.
Conclusion:
The SFMC on POD 1 strongly predicted the hypercoagulable state after gastroenterological surgery than the clinical risk factors and the other fibrin related markers.
Insights
Soluble fibrin monomer complex (SFMC) on postoperative day 1 effectively predicts hypercoagulable states after surgery. High SFMC levels indicate a greater risk, guiding potential anticoagulant therapy decisions.
Area of Science:
- Biochemistry
- Clinical Medicine
- Thrombosis Research
Background:
- Gastroenterological surgery poses a risk for hypercoagulable states.
- Early detection of coagulation activation is crucial for patient management.
Purpose of the Study:
- To evaluate the predictive role of soluble fibrin monomer complex (SFMC) in identifying hypercoagulable states post-gastroenterological surgery.
- To compare SFMC's predictive value against clinical risk factors and other fibrin markers.
Main Methods:
- Prospective data collection from 123 patients undergoing gastroenterological surgery.
- Measurement of SFMC and other fibrin-related markers on postoperative day 1 (POD 1).
- Analysis of associations between SFMC levels and D-dimer elevation on postoperative day 7 (POD 7).
Main Results:
- High SFMC levels on POD 1 were independently associated with elevated D-dimer on POD 7 (OR = 4.31, P = 0.03).
- A SFMC cutoff of 3.8 μg/mL demonstrated good predictive performance (AUC = 0.78).
- Postoperative anticoagulant therapy reduced POD 7 D-dimer levels in patients with high SFMC.
Conclusions:
- SFMC on POD 1 is a strong predictor of hypercoagulable states following gastroenterological surgery.
- SFMC offers superior predictive value compared to clinical risk factors and other fibrin markers.
- SFMC may aid in identifying patients who could benefit from early anticoagulant intervention.