Risk Factors For The Acute Coagulopathy After Intracranial Aneurysm Clipping Surgery

Purpose: To analyze the possible associated risk factors of the acutecoagulopathy after intracranial aneurysm clipping surgery, prevent andintervene early in high-risk patients, reduce the incidence ofcoagulation abnormalities.Method: According to the inclusion and exclusion criteria, weretrospectively reviewed the clinical data of188cases of intracranialaneurysm who were treated in department of neurosurgery, the FirstAffiliated Hospital of Fujian Medical University from January1,2012toDecember31,2013. All cases are divided into normal and abnormal groupsby National Clinical Laboratory Procedures (the third edition) on thecoagulopathy diagnostic criteria, and recorded17relevant factors ofpostoperative coagulopathy, including age, gender, hypertension,glycuresis, Hunt-Hess grade, Fisher grade, preoperative use ofantiepileptic drugs, preoperative use of hemostatic, preoperativeinfection, the operation time, intraoperative total intake, blood loss,intraoperative net fluid intake, blood volume per hour, intraoperativetransfusion, intraoperative use of hemostatic, plasma calciumconcentration difference. Application of SPSS19.0statistical softwarefor analyzing. Univariate analysis was performed using the chi-squaredtest on R×C tables, and multivariate analysis by binary logisticregression analysis. Result: There are17clinical factors in this study, univariate analysisshowed that six clinical factors relating to the acute coagulopathyafter intracranial aneurysm clipping surgery in this study, including age,gender, blood volume per hour, intraoperative net fluid intake,intraoperative use of hemostatic and plasma calcium concentrationdifference. Multivariate analysis indicated4main factors for the acutecoagulation dysfunction after intracranial aneurysm surgery, includingplasma calcium concentration difference>0.30mmol/L, age≥65years,intraoperative net fluid intake≥1500ml and female.Conclusion: The main risk factors relating to the acute coagulationdysfunction after intracranial aneurysm clipping surgery include thefollowing items, such as: pre-and post-operative difference of plasmacalcium concentration>0.30mmol/L, age≥65years, intraoperative netfluid intake≥1500ml and female. thus we should take an attention tochange of postoperative coagulation in the elderly female aneurysmpatients. Furthermore, management of intraoperative net fluid balance andthe postoperative plasma calcium should be emphasized to prevent theoccurrence of acute postoperative coagulopathy.