CLINICAL RELEVANCE OF THE FIBRINOGEN UPTAKE TEST IN PATIENTS UNDERGOING ELECTIVE GENERAL ABDOMINAL-SURGERY - RELATION TO MAJOR THROMBOEMBOLISM AND MORTALITY

Postoperative thromboembolic complications were evaluated in 2578 pati ents undergoing elective abdominal surgery, all receiving prophylaxis with low molecular weight heparin. A positive fibrinogen uptake test ( FUT) developed in 217 patients (8.4%), while 37 patients (1.4%) had ma jor thromboembolism (TE, defined as proximal deep vein thrombosis and/ or pulmonary embolism, verified with phlebography, pulmonary scintigra phy or autopsy). In only 14% a positive FUT was associated with a majo r TE event. In 19% of the patients with major TE the FUT was negative. In multiple logistic regression the independent predictors for major TE were partially different from those for positive FUT. Thirty day mo rtality was 3.0%. There were significant associations between both pos itive FUT and major TE on one hand and mortality on the other (relativ e risks 2.4 and 5.8, respectively). FUT is not a good predictor of maj or TE. Both positive FUT and major TE indicate a significant risk of p ostoperative death.