Resumen de Use of fibrinogen concentrate in surgical and bleeding trauma patients
Carlos Javier Parramon Teixido, Celia González Guerrero, Virginia Bosó Ribelles, Javier Martínez Turrión, Antonio Lozano Andreu, José Bruno Montoro Ronsano
Objective: To assess the influence of fibrinogen concentrate (FC) on survival in bleeding trauma patients with life-threatening hemorrhagic disorders, undergoing surgery or presenting an active bleeding. As secondary objectives, to evaluate when the FC administration maximizes its efficacy and to describe the concomitant treatments administered in order to control bleeding. Method: Observational, retrospective and multi-center study carried out in five trauma areas of five third-level trauma hospitals between June 2012 and July 2017, All trauma patients who received a FC prescription with a reported life-threatening hemorrhage were included. Demographic and analytical data, treatment indication, admission diagnosis, FC dose, survival after 24 hours and seven days and concomitant treatments were collected. Results: Two hundred eleven patients were included with a mean dose of FC administered of 3.63 g (SD 3.18 g). Initially, fibrinogen plasma level was 1.91 g/L (SD 1.17 g/L) which rose to 2.70 g/L (SD 1.29 g/L) after the FC administration. Lower fibrinogen concentrations in conjunction with the presence of surgery or active bleeding are associated with a higher risk of death at seven days (p = 0,033). The most suitable threshold to recommend the FC administration in surgery and active bleeding scenario has been found to be 2 g/dL (p - 0,009 after 24 hours; p = 0,01 after seven days). Finally, the most common concomitant treatment was the erythrocytes concentrate. Conclusions: It has been found a statistically significant relationship between lower fibrinogen plasma levels in patients undergoing surgery or with an active bleeding and higher probability of death after seven days
