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Changes in coagulatory profile after orthopedic surgery
1Department of Orthopedic Surgery, Sin-Lau Christian Hospital, Tainan, Taiwan.
Journal of the Formosan Medical Association = Taiwan Yi Zhi
|September 1, 1995
Summary
Orthopedic surgery temporarily alters blood coagulation, with platelet counts, prothrombin time (PT), and partial thromboplastin time (PTT) showing specific changes post-operation. Understanding these patterns aids in managing perioperative coagulopathy.
Area of Science:
- Hematology
- Orthopedic Surgery
- Coagulation Studies
Background:
- Orthopedic surgery can impact patient hemostasis.
- Perioperative coagulation monitoring is crucial for patient safety.
Purpose of the Study:
- To prospectively evaluate coagulation parameters in patients undergoing orthopedic surgery.
- To identify patterns of change in platelet count, PT, PTT, and fibrinogen post-orthopedic procedures.
Main Methods:
- Prospective evaluation of 65 orthopedic surgery patients.
- Collection of coagulation data (platelet count, PT, PTT, fibrinogen) preoperatively and on postoperative days 1, 3, and 7.
- Correlation analysis with surgical duration, blood loss, and patient demographics.
Main Results:
- Platelet count decreased on POD 1, normalized by POD 3, and increased by POD 7.
- PT and PTT were prolonged on POD 1, with PTT remaining elevated longer.
- Fibrinogen levels increased on POD 3 before returning to baseline.
- Surgical duration and blood loss correlated positively with decreased platelet count.
Conclusions:
- Orthopedic surgery induces predictable, transient changes in coagulation parameters.
- Recognizing these physiologic variations can improve clinical assessment of perioperative coagulopathy.
- Age, sex, operation type, and tourniquet duration did not significantly influence these coagulation patterns.