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Early coagulopathy in patients with ruptured abdominal aortic aneurysm.
Department of Surgery, Sundsvall County Hospital, Sundsvall, Sweden.
Department of Surgery, Sundsvall County Hospital, Sundsvall, Sweden.
Mid Sweden University, Faculty of Science, Technology and Media, Department of applied science and design. Department of Laboratory Medicine, Sundsvall County Hospital, SE-851 86 Sundsvall, Sweden .
2012 (English)In: Clinical and applied thrombosis/hemostasis, ISSN 1076-0296, E-ISSN 1938-2723, Vol. 18, no 1, 96-9 p.Article in journal (Refereed) Published
Abstract [en]

Ruptured abdominal aortic aneurysm (AAA) is associated with a high mortality despite surgical management. Earlier reports indicate that a major cause of immediate intraoperative death in patients with ruptured AAA is related to hemorrhage due to coagulopathy. Acidosis is, besides hypothermia and hemodilution, a possible cause of coagulopathy. The aim of the present study was to investigate the incidence of coagulopathy and acidosis preoperatively in patients with ruptured AAA in relation to the clinical outcome with special regard to the influence of shock. For this purpose, 95 consecutive patients who underwent surgery for AAA (43 ruptured with shock, 12 ruptured without shock, and 40 nonruptured) were included. Coagulopathy was defined as prothrombin time (international normalized ratio [INR]) ≥1.5 and acidosis was defined as base deficit ≥6 mmol/L. Mortality and postoperative complications were recorded. The present study shows a state of acidosis at the start of surgery in 30 of 55 patients with ruptured AAA. However, only in 7 of 55 patients with ruptured AAA a state of preoperative coagulopathy was demonstrated. Furthermore, in our patients with shock due to ruptured AAA only 2 of 12 deaths were due to coagulopathy and bleeding. Indeed, our results show a relatively high incidence of thrombosis-related causes of death in patients with ruptured AAA, indicating a relation to an activated coagulation in these patients. These findings indicate that modern emergency management of ruptured AAA has improved in the attempt to prevent fatal coagulopathy.

Place, publisher, year, edition, pages
2012. Vol. 18, no 1, 96-9 p.
Keyword [en]
bleeding, hemostasis, vascular and endovascular surgery
National Category
Surgery Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:miun:diva-19118DOI: 10.1177/1076029611412361ISI: 000300376800013PubMedID: 21733939Scopus ID: 2-s2.0-84857536114OAI: oai:DiVA.org:miun-19118DiVA: diva2:647208
Available from: 2013-09-10 Created: 2013-06-07 Last updated: 2017-10-09Bibliographically approved

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CiteExportLink to record
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