The reduction of coagulation factor activity R before surgery increases the risk of postoperative neurological complications in patients with acute type A aortic dissection
- VernacularTitle:急性 A 型主动脉夹层患者术前凝血因子活性 R 降低或增加术后神经系统并发症发生风险
- Author:
Qun LANG
1
;
Yijiang LI
1
;
Hao PENG
2
;
Kaitao JIAN
2
Author Information
1. Department of Cardiovascular Surgery, Shenzhen Hospital, The Third School of Clinical Medicine, Southern Medical University, Shenzhen, 518000, Guangdong, P.R.China
2. Department of Cardiovascular Surgery, Shanghai Delta Hospital, Shanghai, 201702, P.R.China
- Publication Type:Journal Article
- Keywords:
Stanford type A aortic dissection;
neurological complications;
emergency surgery;
coagulation factor activity R
- From:
Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
2021;28(07):792-795
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the risk factors for neurological complications after emergency surgery of acute type A aortic dissection. Methods The clinical data of 51 patients with acute Stanford type A aortic dissection who were admitted to Shanghai Delta Hospital from October 2018 to May 2019 were retrospectively analyzed. There were 37 males (72.5%) and 14 females (27.5%), aged 29-85 (55.1±12.3) years. The patients were divided into two groups, including a N1 group (n=12, patients with postoperative neurological insufficiency) and a N0 group (n=39, patients without postoperative neurological insufficiency). The clinical data of the two groups were compared and analyzed. Results There were statistical differences in age (62.6±11.2 years vs. 51.7±11.4 years, P=0.003), preoperative D-dimer (21.7±9.2 μg/L vs.10.8±10.7 μg/L, P=0.001), tracheal intubation time (78.7±104.0 min vs. 19.6±31.8 min, P=0.003), ICU stay time (204.1±154.8 min vs. 110.8±139.9 min, P=0.037) and preoperative coagulation factor activity R (4.0±1.5 vs. 5.1±1.6, P=0.022). Preoperative coagulation factor activity R was the independent risk factor for neurological insufficiency after emergency (OR=2.013, 95%CI 1.008-4.021, P=0.047). Conclusion For patients with pre-emergent acute aortic dissection who are older (over 62.6-64.5 years), with reduced coagulation factor R (less than 4.0), it is recommended to take more active brain protection measures to reduce the occurrence of postoperative neurological complications in patients with acute aortic dissection, and further improve the quality of life.
