Effect of bleeding amount on Galectin-3 level in hip arthroplasties

Introduction: Galectin-3 is a multifunctional protein that is involved in different biological events, different tissues, and plays a relevant role in many different clinical conditions and diseases. Data indicating that galectin-3 plays a role in neuroinflammation and neurodegeneration have been increasing recently. Galectin-3 appears to have a very complex effect on various behavioral patterns. Intraoperative hypotension and blood product transfusions may be associated with postoperative behavioral changes. In our study, we aimed to determine the effect of the amount of bleeding in primary hip arthroplasty on the galectin-3 level and the neurological complications that occur in the early period. Materials and Methods: This study was conducted with the approval of the Ethics Committee of Ordu University Faculty of Medicine (decision dated 14.01.2022 and numbered 2022/03) for patients over the age of 60 who will undergo hip arthroplasty electively in the operating room by the Orthopedics and Traumatology Clinic at the Ministry of Health Ordu Training and Research Hospital, ASA ( It was performed prospectively in patients with ASA Ⅰ/Ⅱ/Ⅲ according to risk class (American Society of Anesthesiologist). For serum Galectin-3 measurements, blood samples were taken preoperatively, at the 24th hour postoperatively and at the 72nd hour postoperatively. At the same time, PCT, CRP and hemogram values were recorded. Serum samples for galectin-3 were stored at −80 °C until analyzed. Results: A total of 45 patients, 27 women (60%) and 18 men (40%), were included in the study. The overall average age of the patients was 70.93±8.16 years. While Galectin-3 levels measured at preoperative, postoperative 24th hour and postoperative 72nd hour did not show a statistically significant difference (p: 0.936), CRP levels showed a significant difference (p <0.001). A statistically significant positive weak correlation was found between Galectin-3 and the amount of intraoperative bleeding (ml) at the 24th postoperative hour. (r=0.323; p=0.030). A statistically significant negative correlation was found between preoperative HGB level and postoperative 24th hour and postoperative 72nd hour Galectin-3 levels (r=-0.415, p=0.005; r=-0.373, p=0.012). Conclusion: As a result, in a major surgery with bleeding, blood pressure fluctuations, amount of bleeding, and blood and blood product transfusion may affect the Galectin-3 level. In our study, close intraoperative follow-up, not allowing low blood pressure, strict bleeding management and fluid therapy positively affect the Galectin-3 level. However, not including patients with comorbidities that cause increased Galectin-3 elevation in the preoperative period is among the reasons affecting the Galectin-3 increase. Galectin-3 level detection can be used as a biomarker in elderly patients with comorbidities, especially considering its impact on inflammatory processes in terms of morbidity and mortality. It seems that there is a need for further studies on the subject for bleeding surgeries in a larger patient population.