# The impact of preoperative anticoagulant administration on postoperative coagulation function and blood loss following posterior lumbar interbody fusion: a case–control study

## TL;DR

This study finds that giving anticoagulants before spine surgery does not significantly affect blood clotting or blood loss after the operation.

## Contribution

The study provides new evidence on the safety of preoperative anticoagulant use in posterior lumbar interbody fusion surgery.

## Key findings

- Preoperative anticoagulants did not significantly affect most coagulation parameters or blood loss after surgery.
- Only prothrombin time (PT) showed a significant difference between groups.
- Surgical segment was the main factor influencing intraoperative blood loss.

## Abstract

Currently, there are few reports on the impact of preoperative anticoagulant administration on perioperative coagulation function and blood loss. Therefore, this study observed the effects of preoperative anticoagulant administration on postoperative coagulation function and blood loss in posterior lumbar interbody fusion (PLIF).

A retrospective analysis was conducted on the data of 61 patients who underwent PLIF from October 2021 to March 2023. Patients who used anticoagulants [low-molecular-weight heparin (LMWH) or indobufen] preoperatively were recorded as the observation group (n = 29), and those who did not were recorded as the control group (n = 32). The observation group was further divided into two subgroups based on the type of anticoagulant, namely the LMWH group (n = 11) and the indobufen group (n = 18). The observation indicators included surgical time, intraoperative blood loss, postoperative drainage volume, number of blood transfusions, incision healing, deep vein thrombosis (DVT) of the lower limbs, postoperative activated partial thrombin time (APTT), prothrombin time (PT), thrombin time (TT), fibrinogen (FIB), platelet (PLT), postoperative hospital stay, and hemoglobin (HB), red blood cells (RBC), and hematocrit (HCT) on the postoperative 1st, 4th, 7th, and last-tested days.

All surgeries completed successfully with incisions healed in grade A, without DVT occurred. There were no significant differences in surgical time, intraoperative blood loss, postoperative drainage volume, number of blood transfusions, and postoperative hospital stay between the two groups (p > 0.05). There were no significant differences in postoperative TT, FIB, APTT, and PLT between the two groups (p > 0.05). However, there was a significant difference in postoperative PT between the two groups (p < 0.05). There were no significant differences in the above-mentioned indicators between the two subgroups (p > 0.05). Multivariate regression analysis indicated that the surgical segment was an independent influencing factor for intraoperative blood loss (p < 0.05). There were no significant differences in HB, RBC, and HCT between the two groups on the postoperative 1st, 4th, 7th, and last-tested days (p > 0.05).

The use of anticoagulants before PLIF has no significant effect on postoperative TT, FIB, APTT, and PLT (except for PT), and does not significantly affect blood loss.