We editorialized on this study published by Zou et al.Gastrointestinal bleeding is a common clinical symptom,and hemocoagulase is frequently used to treat hemorrhagic conditions.However,studies have shown that hemocoa...We editorialized on this study published by Zou et al.Gastrointestinal bleeding is a common clinical symptom,and hemocoagulase is frequently used to treat hemorrhagic conditions.However,studies have shown that hemocoagulase treatment may induce acquired hypofibrinogenemia,further aggravating the bleeding.Zou et al retrospectively analyzed 109 gastrointestinal bleeding cases to explore the hazards underlying hypofibrinogenemia induced by hemocoagulase,and identified higher total dose of hemocoagulase and female sex,as well as low baseline fibrinogen levels as significant hazards.Consequently,clinicians should be aware of both intrinsic and extrinsic risk factors when using hemocoagulase among this patient population,and remain vigilant for the potential development of hemocoagulase-induced hypofibrinogenemia.展开更多
This study aimed to investigate the prevalence and risk factors associated with tigecycline-induced hypofibrinogenemia,providing critical insights for safer clinical drug use.A retrospective analysis was conducted on ...This study aimed to investigate the prevalence and risk factors associated with tigecycline-induced hypofibrinogenemia,providing critical insights for safer clinical drug use.A retrospective analysis was conducted on the medical records of patients with hypoproteinemia who received tigecycline treatment during hospitalization between January 1,2020,and December 31,2023.Key patient information was collected,including age,gender,weight,history of hematological diseases,medication dosage,treatment duration,concomitant medications,serum albumin and fibrinogen(FIB)levels before and after tigecycline administration,hepatic and renal function parameters,and other clinical characteristics.Patients were categorized into adverse drug reaction(ADR)and non-ADR groups,and comparisons were made to identify baseline characteristics and drug-related factors influencing tigecycline-induced FIB level reductions.Among 222 eligible patients,71(31.98%)developed hypofibrinogenemia.Univariate analysis identified significant associations between hypofibrinogenemia and treatment duration(P=0.000),baseline FIB levels(P=0.006),concomitant use of cefoperazone-sulbactam(P=0.034),and concurrent administration of fat emulsion and heparin sodium injections(P<0.044).Further multivariate logistic regression analysis revealed that a baseline FIB level below 5.1 g/L and concomitant use with cefoperazone-sulbactam were independent risk factors for tigecycline-induced FIB reduction.Conversely,a treatment duration of fewer than 9 d and higher albumin levels(light/medium/weight)were protective factors that reduced the risk of hypofibrinogenemia.This study highlighted that tigecycline-induced hypofibrinogenemia was a frequently encountered adverse effect in clinical practice.Patients with hypoproteinemia should undergo thorough evaluation prior to tigecycline administration,with particular attention to baseline FIB and albumin levels.Long-term use should be avoided,and combinations with medications that impair coagulation function should be minimized to mitigate the risk of hypofibrinogenemia associated with tigecycline.展开更多
Objective Hemocoagulase injection based on the venom of Agkistrodon halys Pallas is widely used in the treatment of hemorrhagic disorders.This study aimed to characterize the clinical laboratory findings of hemocoagul...Objective Hemocoagulase injection based on the venom of Agkistrodon halys Pallas is widely used in the treatment of hemorrhagic disorders.This study aimed to characterize the clinical laboratory findings of hemocoagulase-induced hypofibrinogenemia as the associated adverse reaction of hemocoagulase injection.Methods Wie retrospectively enrolled 27 in-patients who were treated with hemocoagulase injection for hemoptysis and developed hypofibrinogenemia during the period of January 1,2015 to March 31,2018.Clinical data were collected and investigated,including clinical manifestations,hemostatic and fibrinolytic parameters,dosage of hemocoagulase,the medication time,and the cryoprecipitate blood product infusion.Differences in fibrinogen,D-dimer,and fibrin/fibrinogen degradation products(FDP)before,during,and after the application of hemocoagulase injection were analyzed statistically.Results Plasma fibrinogen level during medication of hemocoagulase injection decreased significantly compared to that before the treatment(F=1.80,P<0.001),with the average decrease of 2.28 g/L(0.63-3.9 g/L).After withdrawal,fibrinogen level increased significantly compared to that during the medication(F=l.20,P<0.001),but was still lower than that before the medication(F=0.59,P=0.03).The D-dimer level and the FDP level after withdrawal decreased significantly compared to the levels during the medication(F=0.83,P=0.002;Wilcoxon-test,Z=-4.54,P<0.001).Spearman's correlation analyses did not find either fibrinogen change during-before the administration or FDP change after-during the administration was associated with the dosage of hemo coagulase(r=-0.17,P=0.40;r=-0.28,P=0.15;respectively)and the time of recovery from hypofibrinogenemia(r=-0.45,P=0.05;r=0.13,P=0.61;respectively).Conclusion Monitoring both clotting and fibrinolysis parameters is essential in the management of hemoptysis patients treated with hemocoagulase injection.Clinicians should be aware of hypofibrinogenemia and consider discontinuation of the administration of hemocoagulase whenever necessary.展开更多
BACKGROUND With the widespread use of hemocoagulase in patients with gastrointestinal bleeding,clinicians have become increasingly concerned about coagulation dis-orders associated with this medication.Risk factors fo...BACKGROUND With the widespread use of hemocoagulase in patients with gastrointestinal bleeding,clinicians have become increasingly concerned about coagulation dis-orders associated with this medication.Risk factors for hypofibrinogenemia asso-ciated 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 hospit-alized patients treated with hemocoagulase for gastrointestinal bleeding.Hypofib-rinogenemia 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 assess-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 statist-ically 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.展开更多
文摘We editorialized on this study published by Zou et al.Gastrointestinal bleeding is a common clinical symptom,and hemocoagulase is frequently used to treat hemorrhagic conditions.However,studies have shown that hemocoagulase treatment may induce acquired hypofibrinogenemia,further aggravating the bleeding.Zou et al retrospectively analyzed 109 gastrointestinal bleeding cases to explore the hazards underlying hypofibrinogenemia induced by hemocoagulase,and identified higher total dose of hemocoagulase and female sex,as well as low baseline fibrinogen levels as significant hazards.Consequently,clinicians should be aware of both intrinsic and extrinsic risk factors when using hemocoagulase among this patient population,and remain vigilant for the potential development of hemocoagulase-induced hypofibrinogenemia.
基金Anhui Provincial Traditional Chinese Medicine Inh eritance and Innovation Research Project(Clinical category)(Anhui Traditional Chinese Medicine Development Secretary No.20,2024)。
文摘This study aimed to investigate the prevalence and risk factors associated with tigecycline-induced hypofibrinogenemia,providing critical insights for safer clinical drug use.A retrospective analysis was conducted on the medical records of patients with hypoproteinemia who received tigecycline treatment during hospitalization between January 1,2020,and December 31,2023.Key patient information was collected,including age,gender,weight,history of hematological diseases,medication dosage,treatment duration,concomitant medications,serum albumin and fibrinogen(FIB)levels before and after tigecycline administration,hepatic and renal function parameters,and other clinical characteristics.Patients were categorized into adverse drug reaction(ADR)and non-ADR groups,and comparisons were made to identify baseline characteristics and drug-related factors influencing tigecycline-induced FIB level reductions.Among 222 eligible patients,71(31.98%)developed hypofibrinogenemia.Univariate analysis identified significant associations between hypofibrinogenemia and treatment duration(P=0.000),baseline FIB levels(P=0.006),concomitant use of cefoperazone-sulbactam(P=0.034),and concurrent administration of fat emulsion and heparin sodium injections(P<0.044).Further multivariate logistic regression analysis revealed that a baseline FIB level below 5.1 g/L and concomitant use with cefoperazone-sulbactam were independent risk factors for tigecycline-induced FIB reduction.Conversely,a treatment duration of fewer than 9 d and higher albumin levels(light/medium/weight)were protective factors that reduced the risk of hypofibrinogenemia.This study highlighted that tigecycline-induced hypofibrinogenemia was a frequently encountered adverse effect in clinical practice.Patients with hypoproteinemia should undergo thorough evaluation prior to tigecycline administration,with particular attention to baseline FIB and albumin levels.Long-term use should be avoided,and combinations with medications that impair coagulation function should be minimized to mitigate the risk of hypofibrinogenemia associated with tigecycline.
文摘Objective Hemocoagulase injection based on the venom of Agkistrodon halys Pallas is widely used in the treatment of hemorrhagic disorders.This study aimed to characterize the clinical laboratory findings of hemocoagulase-induced hypofibrinogenemia as the associated adverse reaction of hemocoagulase injection.Methods Wie retrospectively enrolled 27 in-patients who were treated with hemocoagulase injection for hemoptysis and developed hypofibrinogenemia during the period of January 1,2015 to March 31,2018.Clinical data were collected and investigated,including clinical manifestations,hemostatic and fibrinolytic parameters,dosage of hemocoagulase,the medication time,and the cryoprecipitate blood product infusion.Differences in fibrinogen,D-dimer,and fibrin/fibrinogen degradation products(FDP)before,during,and after the application of hemocoagulase injection were analyzed statistically.Results Plasma fibrinogen level during medication of hemocoagulase injection decreased significantly compared to that before the treatment(F=1.80,P<0.001),with the average decrease of 2.28 g/L(0.63-3.9 g/L).After withdrawal,fibrinogen level increased significantly compared to that during the medication(F=l.20,P<0.001),but was still lower than that before the medication(F=0.59,P=0.03).The D-dimer level and the FDP level after withdrawal decreased significantly compared to the levels during the medication(F=0.83,P=0.002;Wilcoxon-test,Z=-4.54,P<0.001).Spearman's correlation analyses did not find either fibrinogen change during-before the administration or FDP change after-during the administration was associated with the dosage of hemo coagulase(r=-0.17,P=0.40;r=-0.28,P=0.15;respectively)and the time of recovery from hypofibrinogenemia(r=-0.45,P=0.05;r=0.13,P=0.61;respectively).Conclusion Monitoring both clotting and fibrinolysis parameters is essential in the management of hemoptysis patients treated with hemocoagulase injection.Clinicians should be aware of hypofibrinogenemia and consider discontinuation of the administration of hemocoagulase whenever necessary.
基金Supported by The First Batch of Key Discipline on Public Health in Chongqing.
文摘BACKGROUND With the widespread use of hemocoagulase in patients with gastrointestinal bleeding,clinicians have become increasingly concerned about coagulation dis-orders associated with this medication.Risk factors for hypofibrinogenemia asso-ciated 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 hospit-alized patients treated with hemocoagulase for gastrointestinal bleeding.Hypofib-rinogenemia 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 assess-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 statist-ically 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.
