Publication date: Available online 11 July 2018
Source: Journal of Oral and Maxillofacial Surgery
Author(s): Kun Wu, Jing-shi Lei, Yuan-yuan Mao, Wei Cao, Zhen-Hu Ren, Han-Jiang Wu
Abstract
Purpose
Studies on coagulation parameters (including activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), fibrinogen (FIB), platelet (PLT) and D-dimer) in flap compromise are limited. The aim of the present study is to compare coagulation parameter variables in patients with and without flap compromise.
Methods
In this retrospective cohort study, patients were recruited from the Department of Oral and Maxillofacial Surgery at the Second Xiangya Hospital between July 2016 and July 2017. The primary predictor variable was a set of coagulation parameters. The primary outcome variable was flap compromise. The other variables were age, gender, T stage, smoking and prior radiotherapy history. Descriptive, bivariate, receiver operating characteristic curves and regression statistics were computed. Statistical significance was set at less than 0.05 with 95% reliability.
Results
A total of 503 patients with 42 compromised flaps were identified in this study. Venous thrombosis, arterial thrombosis or no confirmed reason for compromise was observed in 28, 5, and 9 compromised flaps, respectively. Only FIB was associated with flap compromise or venous thrombosis on adjusted analyses, although the predictive values were low on ROC analysis. For patients with D-dimer＜0.4 (μg/mL), the likelihood of venous thrombosis was greater than that for patients with D-dimer≥0.4 (μg/mL) (P=0.0414). For patients with FIB＜3.5 (g/L), the likelihood of venous thrombosis was greater than that for patients with FIB≥3.5 (g/L) (P= 0.0336).
Conclusion
Decreased FIB was associated with a higher rate of flap compromise. In patients with D-dimer＜0.4 (μg/mL) or FIB＜3.5 (g/L), the risk of venous thrombosis was higher.
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