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Observational Study
. 2018 May;97(21):e10830.
doi: 10.1097/MD.0000000000010830.

Low preoperative fibrinogen level is risk factor for neurological complications in acute aortic dissection

Xinliang Guan  1 , Ming Gong, Xiaolong Wang, Junming Zhu, Yongmin Liu, Lizhong Sun, Hongjia Zhang
Affiliations
Observational Study

Low preoperative fibrinogen level is risk factor for neurological complications in acute aortic dissection

Xinliang Guan et al. Medicine (Baltimore). 2018 May.

Abstract

Aortic arch surgery in patients with acute aortic dissection is frequently complicated by neurological complications and coagulopathy. However, the relationship between the coagulation system and neurological complications in patients with acute aortic dissection has not been clarified. Thus, the aim of this study was to investigate the relationship between the coagulation system and neurological complications in patients with acute aortic dissection.From September 2014 to January 2016, a total of 126 patients with acute type A aortic dissection were enrolled. Perioperative characteristics and standard laboratory tests upon admission were analyzed using univariate and multivariate logistic regression analysis in this study. The primary outcome was the correlation between the coagulation system and neurological complications.Univariate logistic regression analysis showed that the neurological complications (+) group underwent more serious and complicated postoperative outcomes. Multivariable logistic regression analysis revealed serum creatinine level (OR, 1.049; 95% CI, 1.011-1.089; P = .01), white blood cell counts (OR, 1.581; 95% CI, 1.216-2.057; P = .001) and fibrinogen concentration upon admission (OR, 0.189; 95% CI, 0.060-0.596; P = .004) as predictors of neurological complications. However, we found that there was no association between the coagulation system and in-hospital mortality.Low preoperative fibrinogen level is the preferred marker for predicting clinical neurological complications in patients with acute type A aortic dissection treated with surgical repair.

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Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
It depicts the results of receiver operating characteristic (ROC) curve analysis for the value of preoperative fibrinogen concentrations in the prediction of neurological complications in patients with acute type A aortic dissection.
Figure 2
Figure 2
The results of the percentiles of neurological injury and in-hospital mortality in terms of cut-off value of the fibrinogen concentration in patients with acute type A aortic dissection.
See this image and copyright information in PMC

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