Effects of preoperative coagulation status on the dynamic changes of postoperative coagulation indices in ATAAD patients and the different changes by gender
- VernacularTitle:急性A型主动脉夹层患者术前凝血状态可能影响围术期凝血指标动态变化及其性别差异
- Author:
Jiawen HU
1
;
Xiantong CAO
1
;
Yang GAO
1
;
Yang YANG
1
;
Tao SHI
1
Author Information
- Publication Type:Journal Article
- Keywords: acute type A aortic dissection(ATAAD); coagulation; dynamic change; gender difference
- From: Journal of Xi'an Jiaotong University(Medical Sciences) 2025;46(1):119-124
- CountryChina
- Language:Chinese
- Abstract: Objective To investigate the effects of preoperative coagulation status on the dynamic changes of postoperative coagulation indices in patients with acute type A aortic dissection(ATAAD)and the differences between different genders.Methods We recruited 337 patients with ATAAD diagnosed by CT angiography who visited The First Affiliated Hospital of Xi'an Jiaotong University from September 2020 to January 2022 and divided them into fibrinogen(FIB)≥2 g/L group and FIB＜2 g/L group.We compared the differences in changes of perioperative coagulation indices of patients in the two groups and differences in the changes between different genders.Results The FIB＜2 g/L group had a larger proportion of male patients,more intraoperative blood transfusion(P=0.020),higher re-operation rate(P=0.035),significantly higher preoperative D-dimer(P＜0.001)and FIB degradation product levels(P＜0.001),but lower platelet counts and plateletcrit(both P＜0.001)than the control group.Platelet counts and plateletcrit for five consecutive postoperative days were lower in the FIB＜2 g/L group than in the control group(both P＜0.001).D-dimer and FIB degradation products were significantly higher in the FIB＜2 g/L group than in the control group before operation and in the 5-day postoperative period.The FIB＜2 g/L group showed a decreasing trend of D-dimer and FIB degradation products in the postoperative period(both P＜0.001);however,there was no significant change in the control group.Preoperative FIB was lower in male patients than in female patients(P＜0.001),and the proportion of low FIB was significantly higher than in females(P=0.003).Preoperative D-dimer(P=0.004)and FIB degradation products(P=0.003)were higher in male group.In male patients,postoperative D-dimer and FIB degradation products were higher in patients with preoperative FIB＜2 g/L at 5 days postoperatively,but there was no statistically significant difference in the changes of D-dimer or FIB degradation products between the two groups in female patients.Conclusion The preoperative coagulation status of ATAAD patients may exert some effects on the dynamic changes of postoperative coagulation indices,which is more pronounced in men.
