Background: The Stanford type A acute aortic dissection (AAD) carries a high risk of mortality and morbidity, and patients undergoing AAD surgery often bleed excessively and require blood products and transfusions.
Objective(s): The goal of this study was to identify the risk factors for coagulopathy after ATAAD repair. 
Methods: This trial was retrospective analysis, and 95 subjects undergoing Stanford type A AAD repair in Beijing Anzhen hospital from January 2013 to December 2014 were enrolled. Patients with TEG-CI ≤-3 after surgery were allocated to coagulopathy group (n=17, average age 48.7 years), whereas patients with TEG-CI >-3 after surgery were allocated to control group(n=78, average age 46.6 years). Multivariate analysis was used to identify risk factors for coagulopathy after surgery.
Results:
17 (17/95) patients were suffered from coagulopathy after surgery. Patients in coagulopathy group had larger amount of fluid drainage than that in control group. Risk factors for postoperative coagulopathy were activated partial thromboplastin time (APTT) (s) at the end of surgery (odds ratio, OR 0.011; 95% confidence interval CI 0.001 ～ 0.021; P = 0.0355), fibrinogen degradation products (FDP) (mg/L) at the end of surgery (odds ratio, OR 0.004; 95% confidence interval CI 0.001 ～ 0.007; P = 0.0220) and platelet count (10*109/L) at the end of surgery (OR -0.02; 95% CI -0.04 ～ 0.00; P = 0.0459). The lower risk of postoperative coagulopathy was related to the platelet count at the end of surgery up to 137 (109/L).
Conclusions: Postoperative coagulopathy could be related to the clinical and experimental variables. In a representative sample of Chinese adults undergoing Stanford type-A AAD surgery, APTT, FDP and platelet count at the end of surgery were independent factors associated with postoperative coagulopathy. Adding haemostatic, such as fibrinogen and prothrombinase complex, is good for improving the recovery of coagulation function to reduce bleeding and postoperative blood transfusion, as well as adding platelet, plasma and other coagulation factors after AAD surgery.


05 / Risk factors for coagulopathy after Stanford type A acute aortic dissection repair