Risk factors for hemocoagulase-associated hypofibrinogenemia in patients with gastrointestinal bleeding

Table 1 Demographics and clinical characteristics, n (%)

Variables	Non-hypofibrinogenemia (n = 73)	Hypofibrinogenemia (n = 36)	P value
Age (years)	76.0 (66.5-82.0)	73.0 (57.3-81.0)	0.29
Sex, female	24 (32.9)	22 (61.1)	0.005a
Body mass index (kg/m2)	20.3 (19.1-21.8)	20.3 (19.2-20.3)	0.183
Total hemocoagulase doses (KU)	3.0 (1-6.5)	5.0 (2.0-11.8)	0.026a
Treatment duration (days)	2 (1-5)	3 (1-6.8)	0.1
ICU admission	4 (5.5)	8 (22.2)	0.021a
Total deaths	14 (19.2)	14 (38.9)	0.027a
Severe blood loss	7 (9.6)	15 (41.7)	0.000a
Bleeding location
Upper gastrointestinal	25 (34.2)	17 (47.2)	0.190
Small bowel	1 (1.4)	1 (2.8)	1.0
Lower gastrointestinal	5 (6.8)	1 (2.8)	0.667
Unknown site of bleeding	42 (57.5)	17 (47.2)	0.310
Cause of bleeding
Esophagogastric varices	3 (4.1)	10 (27.8)	0.001a
Malignant neoplasm	21 (28.8)	8 (22.2)	0.467
Peptic ulcer	10 (13.7)	2 (5.6)	0.341
Ischemic bowel disease	3 (4.1)	0 (0)	0.549
Severe infection	22 (30.1)	8 (22.2)	0.384
Unexplained GIB	14 (19.2)	8 (20.2)	0.710
Concomitant drugs
Cephalosporin	12 (16.4)	7 (19.4)	0.697
Carbopenems	10 (13.7)	3 (8.3)	0.618
CSS	48 (65.8)	27 (75.0)	0.327
Vitamin K1	5 (6.8)	3 (8.3)	1.0
Tranexamic acid	4 (5.5)	3 (8.3)	0.876
Transfusion
PRC	17 (23.3)	16 (44.4)	0.024a
FFP	6 (8.2)	7 (19.4)	0.166
Laboratory tests
Baseline FIB (g/L)	4.11 (3.18-5.44)	2.20 (2.00-2.96)	0.000a
Post-hemocoagulase FIB (g/L)	3.83 (2.81-5.16)	1.23 (0.67-1.62)	0.000a
PLT (× 109/L)	202 (137.5-277.5)	122.5 (79-216.75)	0.001a
WBC (× 109/L)	9.08 (7.11-12.38)	8.00 (5.79-11.51)	0.285
ALT (U/L)	19.00 (14.20-37.78)	20.13 (12.50-34.85)	0.867
AST (U/L)	28.04 (19.90-39.89)	27.89 (20.18-54.28)	0.556
TBil (μmol/L)	11.00 (8.32-20.08)	15.87 (11.51-39.84)	0.003a

^aP < 0.05.

KU: Klobusitzky unit; ICU: Intensive care unit; GIB: Gastrointestinal bleeding; CSS: Carbazochrome sodium sulfonate; PRC: Packed red cell; FFP: Fresh frozen plasma; FIB: Fibrinogen; PLT: Platelet; WBC: White blood cells; ALT: Alanine transaminase; AST: Aspartate transaminase; ALB: Albumin; TBil: Total bilirubin.

Table 2 Multivariate analyses for the risk factors of hemocoagulase-related hypofibrinogenemia

Variables	OR	95%CI	P value
Baseline fibrinogen	0.252	0.137-0.464	0.000a
Total hemocoagulase doses	1.074	1.015-1.137	0.014a
Sex	2.856	1.015-8.037	0.047a

^aP < 0.05.

OR: Odds ratio.

Table 3 Receiver operating characteristic curve analysis of baseline fibrinogen and total hemocoagulase doses: Area under the receiver operating characteristic curve, sensitivity, specificity, and optimal cutoff points

Variables	AUC	95%CI	P value	Cut-off	Sensitivity	Specificity
Baseline fibrinogen	0.850	0.769–0.931	0.000a	3.012	77.8%	80.8%
Total hemocoagulase doses	0.630	0.520–0.740	0.028a	3.5	63.9%	57.5%

^aP < 0.05.

AUC: Area under the receiver operating characteristic curve.