Document Detail


Factor XIII deficiency and postoperative hemorrhage after neurosurgical procedures.
MedLine Citation:
PMID:  11118574     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Factor XIII is of physiological importance for hemostasis, especially in patients undergoing surgery. It catalyzes the enzymatic cross-linking of fibrin monomers into stable polymers and protects polymers from plasmatic and nonspecific degradation. Postoperative hemorrhage in patients with congenital and acquired Factor XIII deficiencies has been described in various surgical fields. However, there are no data about the incidence and clinical relevance of decreased Factor XIII after neurosurgical procedures. The objective of our study was to investigate the association between Factor XIII deficiency and postoperative hemorrhage after intracranial surgery. METHODS: A total of 1264 patients who underwent intracranial operations were reviewed retrospectively. Standard coagulation parameters were monitored during the perioperative course in all patients. Factor XIII testing was performed postoperatively in 34 patients in whom coagulopathies were suspected despite normal platelets, fibrinogen, prothrombin, and partial thromboplastin time. Data were analyzed to evaluate the association of Factor XIII deficiency and major postoperative hemorrhage. RESULTS: In this series of 1264 patients, a total of 20 patients (1. 6%) suffered from a major postoperative hemorrhage. Of the 34 patients with suspected coagulopathies and postoperative Factor XIII testing, 11 had a major postoperative hemorrhage. Normal levels of Factor XIII, defined as more than 60%, were found in 26 of the 34 patients. Factor XIII deficiency, defined as less than 60%, was found in eight patients. All patients with Factor XIII deficiency (n = 8) had a major postoperative hemorrhage. Of the remaining 26 patients with normal Factor XIII levels only three had a postoperative hemorrhage (p < 0.00001, Fisher's exact test). CONCLUSIONS: Decreased Factor XIII activity may be associated with an increased risk of postoperative hemorrhage after intracranial surgery.
Authors:
R Gerlach; A Raabe; M Zimmermann; A Siegemund; V Seifert
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Surgical neurology     Volume:  54     ISSN:  0090-3019     ISO Abbreviation:  Surg Neurol     Publication Date:  2000 Sep 
Date Detail:
Created Date:  2001-01-16     Completed Date:  2001-01-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0367070     Medline TA:  Surg Neurol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  260-4; discussion 264-5     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Johann Wolfgang Goethe-University, Frankfurt/Main, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Brain Neoplasms / surgery*
Factor XIII Deficiency / complications*
Female
Hematoma / diagnosis,  etiology*
Humans
Intracranial Hemorrhages / diagnosis,  etiology*
Male
Middle Aged
Neurosurgical Procedures / methods*
Postoperative Hemorrhage / diagnosis,  etiology*
Retrospective Studies
Time Factors
Tomography, X-Ray Computed

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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