Zou F, Wu MT, Wang YY. Risk factors for hemocoagulase-associated hypofibrinogenemia in patients with gastrointestinal bleeding. World J Gastrointest Surg 2024; 16(11): 3437-3444 [PMID: 39649201 DOI: 10.4240/wjgs.v16.i11.3437]
Corresponding Author of This Article
Yong-Yi Wang, Doctor, Chief Physician, Department of Occupational Disease and Poisoning, The First Affiliated Hospital of Chongqing Medical and Pharmaceutical College/Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning, No. 301 Nancheng Avenue, Nanan District, Chongqing 400060, China. zybk2023@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Nov 27, 2024; 16(11): 3437-3444 Published online Nov 27, 2024. doi: 10.4240/wjgs.v16.i11.3437
Risk factors for hemocoagulase-associated hypofibrinogenemia in patients with gastrointestinal bleeding
Fei Zou, Mian-Tao Wu, Yong-Yi Wang
Fei Zou, Department of Oncology, The First Affiliated Hospital of Chongqing Medical and Pharmaceutical College/Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning, Chongqing 400060, China
Mian-Tao Wu, Department of Laboratory Medicine, State Key Laboratory of Oncology in South China, Guangdong Provincial Clinical Research Center for Cancer, Sun Yat-sen University Cancer Center, Guangzhou 510060, Guangdong Province, China
Yong-Yi Wang, Department of Occupational Disease and Poisoning, The First Affiliated Hospital of Chongqing Medical and Pharmaceutical College/Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning, Chongqing 400060, China
Co-first authors: Fei Zou and Mian-Tao Wu.
Author contributions: Wang YY proposed the concept of this study; Zou F was responsible for the literature review, methodology, data acquisition, and manuscript writing; Wu MT handled data analysis and manuscript review; All authors have read and approved the final manuscript.
Supported by The First Batch of Key Discipline on Public Health in Chongqing.
Institutional review board statement: The study was reviewed and approved by the Medical Ethics Committee of The First Affiliated Hospital of Chongqing Medical and Pharmaceutical College.
Informed consent statement: Due to the study's retrospective nature, the necessity to procure informed consent was exempted.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: The datasets used and/or analysed during the current study available from the corresponding author on reasonable request at zybk2023@163.com.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Yong-Yi Wang, Doctor, Chief Physician, Department of Occupational Disease and Poisoning, The First Affiliated Hospital of Chongqing Medical and Pharmaceutical College/Chongqing Key Laboratory of Prevention and Treatment for Occupational Diseases and Poisoning, No. 301 Nancheng Avenue, Nanan District, Chongqing 400060, China. zybk2023@163.com
Received: March 10, 2024 Revised: August 19, 2024 Accepted: August 23, 2024 Published online: November 27, 2024 Processing time: 234 Days and 11.7 Hours
Abstract
BACKGROUND
With the widespread use of hemocoagulase in patients with gastrointestinal bleeding, clinicians have become increasingly concerned about coagulation disorders associated with this medication. Risk factors for hypofibrinogenemia associated with hemocoagulase are poorly understood.
AIM
To determine risk factors for hemocoagulase-associated hypofibrinogenemia in patients with gastrointestinal bleeding.
METHODS
We performed a retrospective analysis of the medical documentation of hospitalized patients treated with hemocoagulase for gastrointestinal bleeding. Hypofibrinogenemia was defined as a decrease in plasma fibrinogen concentration to less than 2.0 g/L. The included patients were divided into two groups: acquired hypofibrinogenemia group and non-hypofibrinogenemia group. We used logistic regression analysis to identify potential risk factors and established risk assessment criteria by employing a receiver operating characteristic curve.
RESULTS
There were 36 patients in the acquired hypofibrinogenemia group and 73 patients in the non-hypofibrinogenemia group. The hypofibrinogenemia group showed higher rates of intensive care unit admissions (P = 0.021), more female patients (P = 0.005), higher in-hospital mortality (P = 0.027), larger hemocoagulase doses (P = 0.026), more Packed Red Cells transfusions (P = 0.024), and lower baseline fibrinogen levels (P < 0.000). Binary logistic regression was employed to examine the risk factors associated with acquired hypofibrinogenemia. The analysis revealed that baseline fibrinogen [odds ratio (OR) 0.252, 95%CI: 0.137-0.464, P < 0.000], total hemocoagulase doses (OR 1.074, 95%CI: 1.015-1.137, P = 0.014), and female gender (OR 2.856, 95%CI: 1.015–8.037, P = 0.047) were statistically significant risk factors.
CONCLUSION
Higher doses of total hemocoagulase, female gender, and a lower baseline fibrinogen level were risk factors for hemocoagulase-associated hypofibrinogenemia in patients with gastrointestinal bleeding.
Core Tip: In order to identify risk factors for hemocoagulase-associated hypofibrinogenemia, a retrospective study analyzing data from 109 patients with gastrointestinal bleeding was conducted. We found that higher doses of total hemocoagulase, female gender, and a lower baseline fibrinogen level were risk factors for hemocoagulase-associated hypofibrinogenemia in patients with gastrointestinal bleeding.
