Published online Mar 28, 2017. doi: 10.3748/wjg.v23.i12.2209
Peer-review started: November 18, 2016
First decision: December 19, 2016
Revised: January 5, 2017
Accepted: March 2, 2017
Article in press: March 2, 2017
Published online: March 28, 2017
Processing time: 132 Days and 20 Hours
To examine the role of soluble fibrin monomer complex (SFMC) in the prediction of hypercoagulable state after gastroenterological surgery.
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.
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.
The SFMC on POD 1 strongly predicted the hypercoagulable state after gastroenterological surgery than the clinical risk factors and the other fibrin related markers.
Core tip: We found that the plasma level of soluble fibrin monomer complex (SFMC) on POD 1 was more strongly associated with D-dimer elevation on POD 7 than were the clinical risk factors or other fibrin-related markers in 123 cases after gastroenterological surgery, suggesting the possible role of SFMC in the prediction of a hypercoagulable state and subsequent venous thromboembolism. The present study also demonstrated the possibility that the plasma levels of SFMC could be used as an indication for anticoagulant therapy in patients who have undergone gastroenterological surgery.