Risk Factors Of Coagulopathy After Craniotomy For Tumor Resection

Objective: to analyze the risk factors of coagulopathy after craniotomy for tumor resection,and to reduce the incidence of postoperative coagulopathy in high-risk patients by early prevention and intervention.Methods:According to inclusion and exclusion criteria,we collected 156 patients undergoing craniotomy for tumor resection from January 1st,2016 to December 31 st,2018 in the First Affiliated Hospital of Guangxi Medical University.According to the diagnostic criteria of coagulopathy,the patients were divided into coagulopathy group and normal coagulation group.The possible risk factors of coagulopathy we analyzed included age,sex,operation time,intraoperative blood loss,transfusion of red blood cells,transfusion of plasma,transfusion of autologous blood,tumor size,pathology grade of tumor,the average blood calcium concentration?temperature and shock index in 24 hours after operation.We also compared the outcomes between coagulopathy group and normal coagulation group.SPSS22 statistical software was used for statistical analysis of all the data.Chi-square test,t test and rank sum test were used for univariate analysis.Logistic regression was used for multivariate analysis.Results: univariate analysis showed that eight factors in this study were related to coagulopathy after craniotomy for tumor resection,including operation time,intraoperative blood loss,transfusion of red blood cells,transfusion of plasma,tumor size,the average blood calcium concentration ? temperature and shock index in 24 hours after operation.Multivariate analysis showed that intraoperative red blood cell transfusion,average blood calcium concentration and temperature in 24 hours after operation were independent risk factors for coagulopathy after craniotomy for tumor resection.Moreover,compared with the normal group,the outcome of the patients with coagulopathy was worse.Conclusion: the more red blood cells infusion,lower postoperative blood calcium concentration and temperature after craniotomy in 24 h are independent risk factors of coagulopathy.So in order to prevent coagulopathy,we should control the infusion of red blood cells during operation and notice the blood calcium concentration and temperature after surgery timely.