Association of perioperative factor XIII activity levels and other haemostatic markers with the risk of postoperative intracranial haematoma in a selected cohort of neurosurgical patients

Abstract

Low platelet count can cause significant volume postoperative intracranial haematoma and in presence of multiple defects in haemostatic markers appears to be clinically useful to predict the formation of postoperative intracranial haematoma in neurosurgical patients.

Fibrinogen but not factor XIII deficiency is associated with bleeding after craniotomy

“…6 In contrast, in another series of 84 patients undergoing both elective and non-elective intracranial surgery, no difference in fibrinogen levels between patients with and without haematoma has been reported by Idris and colleagues. 7 Interestingly, in this study, fibrinogen levels did not decrease significantly and the mean postoperative fibrinogen level in the haematoma group was as high as 282 mg dl 21 . This might be explained by the different time points of postoperative blood sampling.…”

“…6 A more recent study, however, could not reproduce this finding. 7 We hypothesized that perioperative fibrinogen and FXIII levels would differ between patients with and without severe postoperative bleeding. The aim of this study was to assess perioperative fibrinogen and FXIII levels and also their potential association with severe postoperative bleeding in patients undergoing elective intracranial surgery.…”

Point of care coagulation testing in neurosurgery

“…This corresponds well to results from other studies which found POC tests predictive of perioperative and postoperative blood loss [9][10][11]. Impairment of the haemostatic system is a well-recognised risk factor for the development of postoperative intracranial haemorrhage [12] or haematoma enlargement in spontaneous or traumatic intracranial haemorrhage [13]. Although data regarding the use of POC devices in neurosurgical patients are limited, they suggest that POC testing of haemostasis may have beneficial effects in this patient population.…”

Predictive Value of Whole Blood and Plasma Coagulation Tests for Intra- and Postoperative Bleeding Risk: A Systematic Review

“…patients on antiplatelet or anticoagulant medication and are grouped separately, [80][81][82][83][84][85][86][87][88][89][90][91][92][93][94][95][96] while the remaining 18 studies investigated only standard coagulation tests. [97][98][99][100][101][102][103][104][105][106][107][108][109][110][111][112][113][114] We considered a rating of 14 or above to be of good quality. In total, 58 studies (59%) rated 14 or above, and these are presented in ►Tables 3-8. TEG, ROTEM, and Sonoclot ►Table 3 summarizes the 17 studies that rated !14 and assessed TEG/ROTEM or Sonoclot in adults.…”