The clinical use of soluble fibrin (SF) as a coagulation marker is increasing. However, its diagnostic role in critical coagulopathy during invasive abdominal surgery has not been examined. In the present study, we evaluated of changes in SF and other conventional markers, and statistical examination of risk factors in the Disseminated intravascular coagulation (DIC). 44 highly invasive surgeries (segmental hepatectomy or more, 28; pancreaticoduodenectomy, 9; distal pancreatectomy, 5; splenectomy, 2) were included. After excluding 7 patients who did not develop DIC, 37 patients were classified into 2 groups: the SAC group, in which SAC remained after surgery (n = 16), and the DIC group, which developed DIC (n = 21). All patients were diagnosed with SIRS triggers a hypercoagulable condition (SAC) on POD1 and with DIC on POD2. Multivariate analysis revealed significant differences only in the SF level and FDP (odds ratio at 14.4 and 7.8). A prediction formula was then prepared based on the β value: P = 1 / [1 + exp {-(2.665 × SF + 2.049 × FDP - 1.309)}]. The sensitivity and specificity of the prediction formula were 71% and 94%, respectively. These results showed that the risk factors in the DIC group were SF and FDP on POD1, with SF being the stronger risk factor. Operative stress can be quantified using the SF level on POD1, enabling more specific perioperative management from the perspective of postoperative coagulopathy control.

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