FIBTEM as a predictor of intra- and postoperative blood loss in revision total hip arthroplasty: A prospective observational study

Revision total hip arthroplasty (THA) may cause intra- and postoperative massive bleeding. This prospective observational study evaluated if the maximum clot firmness of FIBTEM (MCF(FIB)) could act as a predictor of perioperative massive bleeding in revision THA. Fifty-eight adult patients undergoing revision THA were included. Pre- and postoperative MCF(FIB), hematological and hemostatic laboratory data, as well as the amount of intra- and postoperative blood loss (IBL and PBL) were obtained. The change rate (MCF(FIB)-C) between the pre- and postoperative MCF(FIB) had a significant correlation with IBL (ρ = 0.431, P = .001). Moreover, PBL had a significant correlation with MCF(FIB)-C (ρ = 0.292, P = .026). The MCF(FIB)-C cut-off value of ≥ 29% showed the highest sensitivity and specificity for predicting IBL ≥ 1000 mL or PBL ≥500 mL. The incidence of red blood cell transfusion in the postoperative period was higher in patients showing MCF(FIB)-C ≥ 29% (34% vs 8%, P = .015). The change rate between pre- and postoperative MCF(FIB) values was correlated well with the amount of IBL or PBL. Moreover, particular change rate of MCF(FIB) could predict massive bleeding in revision THA.