Can Preoperative Sex-Related Differences in Hemostatic Parameters Predict Bleeding in Orthognathic Surgery?

Olsen, Jeppe; Ingerslev, Janne; Thorn, Jens Jørgen; Pinholt, Else Marie; Gram, Jørgen Brodersen; Sidelmann, Johannes Jakobsen

doi:10.1016/j.joms.2016.03.012

Cited by 9 publications

(18 citation statements)

References 21 publications

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“…With regard to orthognathic surgery, similar trends have been identified; however, the effect of patient gender on blood loss still remains up for debate. While numerous studies have investigated orthognathic blood loss, only a few of those stated significant gender-specific alterations in this connection [6,[12][13][14][15][16]. All of these studies analysed the amount of the intraoperative blood loss taking into account the blood loss occurring from mucosal incision to wound closure.…”

Section: Discussionmentioning

confidence: 99%

“…At the end of surgery, the visible intraoperative blood loss (IOB) was determined consisting of the bleeding volume which had occurred from the time of initial mucosal incision to wound closure. For this purpose, the 'subtraction method' was deployed (Table 1): the amount of fluid in the suction canister minus the irrigation fluid used is assumed to be equivalent to the patient's blood loss [11,12,14]. In addition, the weight difference of the throat pack and any surgical gauze used were added to the bleeding volume determined [6,20,21].…”

Section: Blood Lossmentioning

confidence: 99%

“…In a further step, a linear regression analysis was performed taking into account haemostatic parameters differing substantially in terms of gender, as well parameters previously linked to blood loss: patient gender, operation time, age and BMI [6,[12][13][14]16].…”

Section: Regression Analysismentioning

confidence: 99%

“…In this context, patient gender has frequently been discussed as a major contributing factor in terms of the amount of blood loss to be expected, whereby controversial findings were reported. Several authors have stated that male gender is associated with higher bleeding volumes in comparison to female gender [6,[13][14][15][16]. It has previously been suggested that an ampler haemostatic profile in females in comparison with males may trigger gender-specific differences with regard to the bleeding volumes observed [14,15].…”

Section: Introductionmentioning

confidence: 99%

“…Several authors have stated that male gender is associated with higher bleeding volumes in comparison to female gender [6,[13][14][15][16]. It has previously been suggested that an ampler haemostatic profile in females in comparison with males may trigger gender-specific differences with regard to the bleeding volumes observed [14,15]. However, the underlying mechanisms potentially affecting blood loss in this regard have scarcely been investigated.…”

Section: Introductionmentioning

confidence: 99%

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Gender-specific differences in haemostatic parameters and their influence on blood loss in bimaxillary surgery

et al. 2022

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Objective The objectives of this prospective cohort study were to establish gender-related differences in blood loss and haemostatic profiles associated with bimaxillary surgery. In addition, we aimed to identify if any gender differences could be established which might help predict blood loss volume. Materials and methods Fifty-four patients (22 males; 32 females) undergoing bimaxillary surgery for skeletal dentofacial deformities were eligible for inclusion. Blood samples were taken 1 day preoperatively and 48 h postoperatively for detailed gender-specific coagulation analysis incorporating global coagulation assays (endogenous thrombin potential) and specific coagulation parameters. Blood loss was measured at two different time points: (1) the end of surgery, visible intraoperative blood loss (IOB) using ‘subtraction method’; and (2) 48 h postoperatively perioperative bleeding volume (CBL-48 h) using ‘haemoglobin-balance method’ and Nadler’s formula. Correlation and regression analyses were performed to identify relevant parameters affecting the amount of blood loss. Results Significant differences in IOB and CBL-48 h were observed (p < 0.001). Men had higher IOB versus women, lacking statistical significance (p = 0.056). In contrast, men had significantly higher CLB-48 h (p = 0.019). Reduced CBL-48 h was shown to be most closely associated with the level of Antithrombin-III being decreased in females. Conclusions Male gender is associated with higher IOB and CBL-48 compared with females. Gender does not affect IOB regarding haemostatic profile but does correlate strongly with procedure length. Conversely, CBL-48 is closely associated with gender-specific imbalances in the anticoagulant system. Clinical relevance Knowledge of gender-related differences will help clinicians establish predictive factors regarding excessive blood loss in orthognathic surgery and identify at-risk patients.

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