Risk factors of acute coagulation dysfunction after aneurysmal subarachnoid hemorrhage

作     者：Guo-Rong Chen Pei-Sen Yao Chu-Bin Liu Huang-Cheng Shang-Guan Shu-Fa Zheng Liang-Hong Yu Yuan-Xiang Lin Zhang-Ya Lin De-Zhi Kang Chen Guo-Rong;Yao Pei-Sen;Liu Chu-Bin;Shang-Guan Huang-Cheng;Zheng Shu-Fa;Yu Liang-Hong;Lin Yuan-Xiang;Lin Zhang-Ya;Kang De-Zhi

作者机构：Department of NeurosurgeryThe First Affiliated Hospital of Fujian Medical UniversityNO.20 Chazhong RoadTaijiang DistrictFuzhou City 350004FujianChina Department of NeurosurgeryThe Second Affiliated Hospital of Fujian Medical UniversityQuanzhou City 362000FujianChina 

出 版 物：《Chinese Neurosurgical Journal》 (中华神经外科杂志（英文）)

年 卷 期：2018年第4卷第4期

页      面：204-209页

学科分类：1002[医学-临床医学] 1001[医学-基础医学(可授医学、理学学位)] 100214[医学-肿瘤学] 1009[医学-特种医学] 10[医学] 

基　　金：supported by the Young and Middle-aged Backbone Key Research Project of National Health and Family Planning Commission of Fujian Province Natural Science Funding of Fujian Province special fund for Public Health of Fujian Province Department of Finance Key Clinical Specialty Discipline Construction Program of Fujian,P.R.C major project of Fujian Provincial Department of Science and Technology 

主　　题：Risk factors Coagulation dysfunction Aneurysmal subarachnoid hemorrhage 

摘      要：Background: Although coagulopathy have been proved to be a contributor to a poor outcome of aneurysmal subarachnoid hemorrhage (aSAH), the risk factors for triggering coagulation abnormalities have not been studied after aneurysm clipping. Methods: We investigated risk factors of coagulopathy and analyzed the relationship between acute coagulopathy and outcome after aneurysm clipping. The clinical data of 137 patients with ruptured CA admitted to our institution was collected and retrospectively reviewed. Patient demographic data (age, sex), smoking, alcohol use, hypertension, diabetes, Hunt-Hess grade, Fisher grade, operation time, intraoperative total infusion volume, intraoperative blood loss, intraoperative transfusion, intraoperative hemostatic drug treatment, calcium reduction (preoperative free calcium concentration–postoperative free calcium concentration) were recorded. Coagulation was assessed within 24 h. Postoperative hemorrhage and infarction, deep venous thrombosis (DVT), and mortality were analyzed. Results: Coagulopathy was detected in a total of 51 cases (group I), while not in 86 cases (group II). Univariable analysis demonstrated that age, smoking, alcohol use, intraoperative total infusion volume, intraoperative blood loss, intraoperative transfusion, and calcium reduction (≥1.2 mg/dl) were related to coagulopathy. Non-conditional logistic regression analysis showed that age [OR, 1.037 (95% CI, 1.001–1.074);p=0.045] and calcium reduction (≥1.2 mg/dl) [OR, 5.509 (95% CI, 1.900–15.971);p=0.002] were considered as the risk factors for coagulopathy. Hunt-Hess grade [OR, 2.641 (95% CI, 1.079–6.331);p=0.033] and operation time [OR, 0.107 (95% CI, 1.012–0.928);p=0.043] were considered as the risk factors for hypocoagulopathy. There were 6 cases (11.7%) with cerebral infarction in group I, while 6 cases (6.98%) in group II (χ2=0.918, p=0.338). There were 4 cases (7.84%) with rebleeding in group I, while 5 cases (5.81%) in group II (χ2=0.215, p=0.643). Th