Abstract
Introduction. Prospective evaluation of fibrinogen levels preoperatively and postoperatively in patients with idiopathic scoliosis undergoing posterior spinal fusion (PSF) and segmental spinal instrumentation (SSI) who received Amicar to decrease perioperative blood loss. Our previous randomized, double-blind (Amicar and control) study demonstrated a rise in fibrinogen levels on the first postoperative day in the Amicar group, but not in the control group. Fibrinogen levels were not measured on the remaining postoperative days.
Methods. We analyzed fibrinogen levels preoperatively and on all postoperative days (4 or 5 days) until discharge in 51 consecutive patients with idiopathic scoliosis, who received Amicar and underwent a PSF and SSI.
Results. There were 41 females and 10 males with a mean age at surgery of 14.2±1.8 years. Their mean hospitalization was 4.6±0.8 days. Their mean estimated intraoperative blood loss was 766±308ml and postoperative suction drainage 532±186ml for a total perioperative blood loss of 1297±311ml. The perioperative transfusion requirements were 0.5±0.6 units per patient. The preoperative fibrinogen was 255.5±58.3 mg/dl, and it rose steadily throughout the postoperative period to 680.9±111.9 mg/dl on the fifth postoperative day. There were no complications related to the use of Amicar.
Conclusions. Fibrinogen levels rise steadily throughout the postoperative period. The significance of this increase is unknown. Was it due to the use of Amicar or just the effects of surgery itself? Further investigations will be necessary.
Correspondence should be addressed to: Dr Caroline Goldberg, The Research Centre, Our Lady’s Children’s Hospital Crumlin, Dublin 12, Ireland.
